If you have come onto this site, I would first of all like to thank you for attending one of my lectures. I believe that anyone who speaks has the potential of accidentally misquoting or misinterpreting a study. Therefore, I present to you the citations of my Crystalloid Journey work so that you could read these articles for yourself.

Crystalloid Journey Citations

Lobo DN, Stanga Z, Aloysius MM, Wicks C, Nunes QM, Ingram KL, Risch L, Allison SP. Effect of volume loading with 1 liter intravenous infusions of 0.9% saline, 4% succinylated gelatine (Gelofusine) and 6% hydroxyethyl starch (Voluven) on blood volume and endocrine responses: a randomized, three-way crossover study in healthy volunteers. Crit Care Med. 2010 Feb;38(2):464-70. doi: 10.1097/CCM.0b013e3181bc80f1. PMID: 19789444.
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Ragaller MJ, Theilen H, Koch T. Volume replacement in critically ill patients with acute renal failure. J Am Soc Nephrol. 2001 Feb;12 Suppl 17:S33-9. PMID: 11251029.
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Bark BP, Persson J, Grände PO. Importance of the infusion rate for the plasma expanding effect of 5% albumin, 6% HES 130/0.4, 4% gelatin, and 0.9% NaCl in the septic rat. Crit Care Med. 2013 Mar;41(3):857-66. doi: 10.1097/CCM.0b013e318274157e. PMID: 23318490.
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Awad S, Allison SP, Lobo DN. The history of 0.9% saline. Clin Nutr. 2008 Apr;27(2):179-88. doi: 10.1016/j.clnu.2008.01.008. Epub 2008 Mar 3. PMID: 18313809.
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Lewins, Robert. Injection of Saline Solutions into the Veins. (1832). The Boston Medical and Surgical Journal, 6(24), 373–375.

Hartmann AF, Senn MJ. STUDIES IN THE METABOLISM OF SODIUM r-LACTATE. II. RESPONSE OF HUMAN SUBJECTS WITH ACIDOSIS TO THE INTRAVENOUS INJECTION OF SODIUM r-LACTATE. J Clin Invest. 1932 Mar;11(2):337-44. doi: 10.1172/JCI100415. PMID: 16694042; PMCID: PMC435817.
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Weinberg L, Collins N, Van Mourik K, Tan C, Bellomo R. Plasma-Lyte 148: A clinical review. World J Crit Care Med. 2016 Nov 4;5(4):235-250. doi: 10.5492/wjccm.v5.i4.235. PMID: 27896148; PMCID: PMC5109922.
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Rizoli S. PlasmaLyte. J Trauma. 2011 May;70(5 Suppl):S17-8. doi: 10.1097/TA.0b013e31821a4d89. PMID: 21841561.
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Brown RM, Wang L, Coston TD, Krishnan NI, Casey JD, Wanderer JP, Ehrenfeld JM, Byrne DW, Stollings JL, Siew ED, Bernard GR, Self WH, Rice TW, Semler MW. Balanced Crystalloids versus Saline in Sepsis. A Secondary Analysis of the SMART Clinical Trial. Am J Respir Crit Care Med. 2019 Dec 15;200(12):1487-1495. doi: 10.1164/rccm.201903-0557OC. PMID: 31454263; PMCID: PMC6909845.
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Li H, Sun SR, Yap JQ, Chen JH, Qian Q. 0.9% saline is neither normal nor physiological. J Zhejiang Univ Sci B. 2016 Mar;17(3):181-7. doi: 10.1631/jzus.B1500201. PMID: 26984838; PMCID: PMC4794509.
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Wilcox CS. Regulation of renal blood flow by plasma chloride. J Clin Invest. 1983 Mar;71(3):726-35. doi: 10.1172/jci110820. PMID: 6826732; PMCID: PMC436923.
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Quilley CP, Lin YS, McGiff JC. Chloride anion concentration as a determinant of renal vascular responsiveness to vasoconstrictor agents. Br J Pharmacol. 1993 Jan;108(1):106-10. doi: 10.1111/j.1476-5381.1993.tb13447.x. PMID: 8428200; PMCID: PMC1907694.
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Chowdhury AH, Cox EF, Francis ST, Lobo DN. A randomized, controlled, double-blind crossover study on the effects of 2-L infusions of 0.9% saline and plasma-lyte® 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers. Ann Surg. 2012 Jul;256(1):18-24. doi: 10.1097/SLA.0b013e318256be72. Erratum in: Ann Surg. 2013 Dec;258(6):1118. PMID: 22580944.
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McCluskey SA, Karkouti K, Wijeysundera D, Minkovich L, Tait G, Beattie WS. Hyperchloremia after noncardiac surgery is independently associated with increased morbidity and mortality: a propensity-matched cohort study. Anesth Analg. 2013 Aug;117(2):412-21. doi: 10.1213/ANE.0b013e318293d81e. Epub 2013 Jun 11. PMID: 23757473.
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Myburgh JA, Mythen MG. Resuscitation fluids. N Engl J Med. 2013 Sep 26;369(13):1243-51. doi: 10.1056/NEJMra1208627. PMID: 24066745.
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Noritomi DT, Soriano FG, Kellum JA, Cappi SB, Biselli PJ, Libório AB, Park M. Metabolic acidosis in patients with severe sepsis and septic shock: a longitudinal quantitative study. Crit Care Med. 2009 Oct;37(10):2733-9. doi: 10.1097/ccm.0b013e3181a59165. PMID: 19885998.
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Neyra JA, Canepa-Escaro F, Li X, Manllo J, Adams-Huet B, Yee J, Yessayan L; Acute Kidney Injury in Critical Illness Study Group. Association of Hyperchloremia With Hospital Mortality in Critically Ill Septic Patients. Crit Care Med. 2015 Sep;43(9):1938-44. doi: 10.1097/CCM.0000000000001161. PMID: 26154934; PMCID: PMC4537691.
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Suetrong B, Pisitsak C, Boyd JH, Russell JA, Walley KR. Hyperchloremia and moderate increase in serum chloride are associated with acute kidney injury in severe sepsis and septic shock patients. Crit Care. 2016 Oct 6;20(1):315. doi: 10.1186/s13054-016-1499-7. PMID: 27716310; PMCID: PMC5053142.
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Modi MP, Vora KS, Parikh GP, Shah VR. A comparative study of impact of infusion of Ringer’s Lactate solution versus normal saline on acid-base balance and serum electrolytes during live related renal transplantation. Saudi J Kidney Dis Transpl. 2012 Jan;23(1):135-7. PMID: 22237237.
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Khajavi MR, Etezadi F, Moharari RS, Imani F, Meysamie AP, Khashayar P, Najafi A. Effects of normal saline vs. lactated ringer’s during renal transplantation. Ren Fail. 2008;30(5):535-9. doi: 10.1080/08860220802064770. PMID: 18569935.
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Piper GL, Kaplan LJ. Fluid and electrolyte management for the surgical patient. Surg Clin North Am. 2012 Apr;92(2):189-205, vii. doi: 10.1016/j.suc.2012.01.004. Epub 2012 Feb 9. PMID: 22414407.
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Andersen LW, Mackenhauer J, Roberts JC, Berg KM, Cocchi MN, Donnino MW. Etiology and therapeutic approach to elevated lactate levels. Mayo Clin Proc. 2013 Oct;88(10):1127-40. doi: 10.1016/j.mayocp.2013.06.012. PMID: 24079682; PMCID: PMC3975915.
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Ichai C, Orban JC, Fontaine E. Sodium lactate for fluid resuscitation: the preferred solution for the coming decades? Crit Care. 2014 Jul 7;18(4):163. doi: 10.1186/cc13973. PMID: 25043707; PMCID: PMC4095570.
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Nalos M, Leverve X, Huang S, Weisbrodt L, Parkin R, Seppelt I, Ting I, Mclean A. Half-molar sodium lactate infusion improves cardiac performance in acute heart failure: a pilot randomised controlled clinical trial. Crit Care. 2014 Mar 25;18(2):R48. doi: 10.1186/cc13793. PMID: 24666826; PMCID: PMC4057379.
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Weinberg L, Collins N, Van Mourik K, Tan C, Bellomo R. Plasma-Lyte 148: A clinical review. World J Crit Care Med. 2016 Nov 4;5(4):235-250. doi: 10.5492/wjccm.v5.i4.235. PMID: 27896148; PMCID: PMC5109922.
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Spriet I, Lagrou K, Maertens J, Willems L, Wilmer A, Wauters J. Plasmalyte: No Longer a Culprit in Causing False-Positive Galactomannan Test Results. J Clin Microbiol. 2016 Mar;54(3):795-7. doi: 10.1128/JCM.02813-15. Epub 2015 Dec 30. PMID: 26719444; PMCID: PMC4767971.
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Stocker RA. “Normal” Saline and Co: What Is Normal? Crit Care Med. 2016 Dec;44(12):2282-2283. doi: 10.1097/CCM.0000000000002030. PMID: 27858813.
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Zampieri FG, Ranzani OT, Azevedo LC, Martins ID, Kellum JA, Libório AB. Lactated Ringer Is Associated With Reduced Mortality and Less Acute Kidney Injury in Critically Ill Patients: A Retrospective Cohort Analysis. Crit Care Med. 2016 Dec;44(12):2163-2170. doi: 10.1097/CCM.0000000000001948. PMID: 27495820.
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Shaw AD, Bagshaw SM, Goldstein SL, Scherer LA, Duan M, Schermer CR, Kellum JA. Major complications, mortality, and resource utilization after open abdominal surgery: 0.9% saline compared to Plasma-Lyte. Ann Surg. 2012 May;255(5):821-9. doi: 10.1097/SLA.0b013e31825074f5. PMID: 22470070.
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Gupta RG, Hartigan SM, Kashiouris MG, Sessler CN, Bearman GM. Early goal-directed resuscitation of patients with septic shock: current evidence and future directions. Crit Care. 2015 Aug 28;19(1):286. doi: 10.1186/s13054-015-1011-9. PMID: 26316210; PMCID: PMC4552276.
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Ince C, Groeneveld AB. The case for 0.9% NaCl: is the undefendable, defensible? Kidney Int. 2014 Dec;86(6):1087-95. doi: 10.1038/ki.2014.193. Epub 2014 Jul 9. PMID: 25007167.
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Hammond NE, Taylor C, Saxena M, Liu B, Finfer S, Glass P, Seppelt I, Willenberg L, Myburgh J. Resuscitation fluid use in Australian and New Zealand Intensive Care Units between 2007 and 2013. Intensive Care Med. 2015 Sep;41(9):1611-9. doi: 10.1007/s00134-015-3878-y. Epub 2015 Jun 3. PMID: 26077073.
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McFarlane C, Lee A. A comparison of Plasmalyte 148 and 0.9% saline for intra-operative fluid replacement. Anaesthesia. 1994 Sep;49(9):779-81. doi: 10.1111/j.1365-2044.1994.tb04450.x. PMID: 7978133.
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Young JB, Utter GH, Schermer CR, Galante JM, Phan HH, Yang Y, Anderson BA, Scherer LA. Saline versus Plasma-Lyte A in initial resuscitation of trauma patients: a randomized trial. Ann Surg. 2014 Feb;259(2):255-62. doi: 10.1097/SLA.0b013e318295feba. PMID: 23732264.
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Young P, Bailey M, Beasley R, Henderson S, Mackle D, McArthur C, McGuinness S, Mehrtens J, Myburgh J, Psirides A, Reddy S, Bellomo R; SPLIT Investigators; ANZICS CTG. Effect of a Buffered Crystalloid Solution vs Saline on Acute Kidney Injury Among Patients in the Intensive Care Unit: The SPLIT Randomized Clinical Trial. JAMA. 2015 Oct 27;314(16):1701-10. doi: 10.1001/jama.2015.12334. Erratum in: JAMA. 2015 Dec 15;314(23):2570. PMID: 26444692.
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Self WH, Semler MW, Wanderer JP, Wang L, Byrne DW, Collins SP, Slovis CM, Lindsell CJ, Ehrenfeld JM, Siew ED, Shaw AD, Bernard GR, Rice TW; SALT-ED Investigators. Balanced Crystalloids versus Saline in Noncritically Ill Adults. N Engl J Med. 2018 Mar 1;378(9):819-828. doi: 10.1056/NEJMoa1711586. Epub 2018 Feb 27. PMID: 29485926; PMCID: PMC5846618.
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Semler MW, Self WH, Wanderer JP, Ehrenfeld JM, Wang L, Byrne DW, Stollings JL, Kumar AB, Hughes CG, Hernandez A, Guillamondegui OD, May AK, Weavind L, Casey JD, Siew ED, Shaw AD, Bernard GR, Rice TW; SMART Investigators and the Pragmatic Critical Care Research Group. Balanced Crystalloids versus Saline in Critically Ill Adults. N Engl J Med. 2018 Mar 1;378(9):829-839. doi: 10.1056/NEJMoa1711584. Epub 2018 Feb 27. PMID: 29485925; PMCID: PMC5846085.
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Brown RM, Wang L, Coston TD, Krishnan NI, Casey JD, Wanderer JP, Ehrenfeld JM, Byrne DW, Stollings JL, Siew ED, Bernard GR, Self WH, Rice TW, Semler MW. Balanced Crystalloids versus Saline in Sepsis. A Secondary Analysis of the SMART Clinical Trial. Am J Respir Crit Care Med. 2019 Dec 15;200(12):1487-1495. doi: 10.1164/rccm.201903-0557OC. PMID: 31454263; PMCID: PMC6909845.
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Young PJ. Balanced Crystalloids or 0.9% Saline in Sepsis. Beyond Reasonable Doubt? Am J Respir Crit Care Med. 2019 Dec 15;200(12):1456-1458. doi: 10.1164/rccm.201908-1669ED. PMID: 31513748; PMCID: PMC6909834.
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Zampieri FG, Machado FR, Biondi RS, Freitas FGR, Veiga VC, Figueiredo RC, Lovato WJ, Amêndola CP, Serpa-Neto A, Paranhos JLR, Guedes MAV, Lúcio EA, Oliveira-Júnior LC, Lisboa TC, Lacerda FH, Maia IS, Grion CMC, Assunção MSC, Manoel ALO, Silva-Junior JM, Duarte P, Soares RM, Miranda TA, de Lima LM, Gurgel RM, Paisani DM, Corrêa TD, Azevedo LCP, Kellum JA, Damiani LP, Brandão da Silva N, Cavalcanti AB; BaSICS investigators and the BRICNet members. Effect of Intravenous Fluid Treatment With a Balanced Solution vs 0.9% Saline Solution on Mortality in Critically Ill Patients: The BaSICS Randomized Clinical Trial. JAMA. 2021 Aug 10;326(9):1–12. doi: 10.1001/jama.2021.11684. Epub ahead of print. PMID: 34375394; PMCID: PMC8356144.
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Zampieri FG, Machado FR, Biondi RS, Freitas FGR, Veiga VC, Figueiredo RC, Lovato WJ, Amêndola CP, Serpa-Neto A, Paranhos JLR, Lúcio EA, Oliveira-Júnior LC, Lisboa TC, Lacerda FH, Maia IS, Grion CMC, Assunção MSC, Manoel ALO, Corrêa TD, Guedes MAVA, Azevedo LCP, Miranda TA, Damiani LP, Brandão da Silva N, Cavalcanti AB. Association between Type of Fluid Received Prior to Enrollment, Type of Admission, and Effect of Balanced Crystalloid in Critically Ill Adults: A Secondary Exploratory Analysis of the BaSICS Clinical Trial. Am J Respir Crit Care Med. 2022 Jun 15;205(12):1419-1428. doi: 10.1164/rccm.202111-2484OC. PMID: 35349397.
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Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults: Simon Finfer, M.D., Sharon Micallef, B.N., Naomi Hammond, Ph.D., Leanlove Navarra, B.S.N., Rinaldo Bellomo, M.D., Ph.D., Laurent Billot, M.Res., Anthony Delaney, M.D., Ph.D., Martin Gallagher, M.D., Ph.D., David Gattas, M.D., Qiang Li, M.Biostat., Diane Mackle, M.N., JayaFinfer S, Micallef S, Hammond N, Navarra L, Bellomo R, Billot L, Delaney A, Gallagher M, Gattas D, Li Q, Mackle D, Mysore J, Saxena M, Taylor C, Young P, Myburgh J; PLUS Study Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group. Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults. N Engl J Med. 2022 Jan 18. doi: 10.1056/NEJMoa2114464. Epub ahead of print. PMID: 35041780.
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Hammond, Naomi & Zampieri, Fernando & Di Tanna, Gian Luca & Garside, Tessa & Adigbli, Derick & Cavalcanti, Alexandre & Machado, Flavia & Micallef, Sharon & Myburgh, John & Ramanan, Mahesh & Rice, Todd & Semler, Matthew & Young, Paul & Venkatesh, Balasubramanian & Finfer, Simon & Delaney, Anthony. (2022). Balanced Crystalloids versus Saline in Critically Ill Adults — A Systematic Review with Meta-Analysis. NEJM Evidence. 1. 10.1056/EVIDoa2100010.
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Fluids in DKA

Mahler SA, Conrad SA, Wang H, Arnold TC. Resuscitation with balanced electrolyte solution prevents hyperchloremic metabolic acidosis in patients with diabetic ketoacidosis. Am J Emerg Med. 2011 Jul;29(6):670-4. doi: 10.1016/j.ajem.2010.02.004. Epub 2010 May 1. PMID: 20825879.
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Self WH, Evans CS, Jenkins CA, Brown RM, Casey JD, Collins SP, Coston TD, Felbinger M, Flemmons LN, Hellervik SM, Lindsell CJ, Liu D, McCoin NS, Niswender KD, Slovis CM, Stollings JL, Wang L, Rice TW, Semler MW; Pragmatic Critical Care Research Group. Clinical Effects of Balanced Crystalloids vs Saline in Adults With Diabetic Ketoacidosis: A Subgroup Analysis of Cluster Randomized Clinical Trials. JAMA Netw Open. 2020 Nov 2;3(11):e2024596. doi: 10.1001/jamanetworkopen.2020.24596. PMID: 33196806; PMCID: PMC7670314.
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Ramanan M, Attokaran A, Murray L, Bhadange N, Stewart D, Rajendran G, Pusapati R, Petty M, Garrett P, Kruger P, Peake S, Billot L, Venkatesh B; SCOPE-DKA Collaborators and Queensland Critical Care Research Network (QCCRN). Sodium chloride or Plasmalyte-148 evaluation in severe diabetic ketoacidosis (SCOPE-DKA): a cluster, crossover, randomized, controlled trial. Intensive Care Med. 2021 Nov;47(11):1248-1257. doi: 10.1007/s00134-021-06480-5. Epub 2021 Oct 5. PMID: 34609547.
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Alghamdi NA, Major P, Chaudhuri D, Tsui J, Brown B, Self WH, Semler MW, Ramanan M, Rochwerg B. Saline Compared to Balanced Crystalloid in Patients With Diabetic Ketoacidosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Crit Care Explor. 2022 Jan 6;4(1):e0613. doi: 10.1097/CCE.0000000000000613. PMID: 35018349; PMCID: PMC8740878.
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Curran JD, Major P, Tang K, Bagshaw SM, Dionne JC, Menon K, Rochwerg B. Comparison of Balanced Crystalloid Solutions: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Crit Care Explor. 2021 May 14;3(5):e0398. doi: 10.1097/CCE.0000000000000398. PMID: 34036269; PMCID: PMC8133105.
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