Buffered solutions versus 0.9% saline for resuscitation in critically ill adults and children.
Delgado Moya FP et al., 2026 · 34 studies included
Summary
Thirty-four studies, 37,859 critically ill adults/children. Included search through July 2023; June 2025 search results were not fully incorporated.
Conclusion
Buffered fluids produced little/no overall mortality difference (OR 0.95, 95% CI 0.90–1.01; high certainty); AKI OR 0.87 (0.75–1.02; moderate certainty). Acid-base effects differ from survival effects. Do not label the publication an exhaustive synthesis through 2026; retain later RCT/IPD evidence and indication-specific guidance, including neurocritical fluid considerations.