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Balanced Multielectrolyte Solution No Benefit for Patients in ICU

No reduction seen in risk for death or acute kidney injury with BMES versus saline for critically ill patients in ICU

MONDAY, Jan. 31, 2022 (HealthDay News) — For critically ill patients in the intensive care unit (ICU), use of a balanced multielectrolyte solution (BMES) does not reduce the risk for death or acute kidney injury compared with use of saline, according to a study published online Jan. 18 in the New England Journal of Medicine.

Simon Finfer, M.D., from the University of New South Wales in Sydney, and colleagues conducted a randomized controlled trial involving critically ill patients recruited from 53 ICUs in Australia and New Zealand. Overall, 2,515 patients were randomly assigned to receive BMES and 2,522 were randomly assigned to saline as fluid therapy for 90 days in the ICU.

The researchers found that death within 90 days of randomization occurred in 21.8 and 22.0 percent of patients in the BMES and saline groups, respectively, for a difference of −0.15 percentage points (95 percent confidence interval, −3.60 to 3.30; P = 0.90). New renal-replacement therapy was initiated in 12.7 and 12.9 percent of patients in the BMES and saline groups, respectively, for a difference of −0.20 percentage points (95 percent confidence interval, −2.96 to 2.56). There was no meaningful difference observed in the number of adverse and serious adverse events between the groups.

“Our data suggest that the use of either BMES or saline for fluid therapy in the ICU resulted in similar outcomes, but our results are also consistent with an increase or decrease of approximately 3 percentage points in the risk of death or receipt of new renal-replacement therapy,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical and health care industries.

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