Hey! It's Saline vs. LR Again!

Since we've settled rocuronium vs. succinylcholine ....

Just a couple weeks ago, we took a brief look at fluid selection for pancreatitis – and now we’re back to fluid selection in sepsis.

This is an article performing a secondary reanalysis of CLOVERS, the “liberal vs. restrictive” trial that’s part of efforts to deconstruct the SEP-1 bundle into What Really Matters.

The key figure:

It’s a non-randomized comparison, so differences between cohorts could have occurred due to Choices, rather than chance. Approximately the same numbers of each were in the liberal vs. restricted fluid arms, and likewise fluid volumes administered were similar without much crossover between fluid types.

These data look a lot like the reanalysis from BaSICS – and yet another piece of data where saline is inferior. The magnitude of effect is fleeting, as large trials have demonstrated, but none of them ever make a case favoring saline.