6/29/23, 1:38 AM PLUS Pathway Feedback Search Clinical Topics Home Studies PLUS PLUS Trial question What is the role of balanced multielectrolyte solution in critically ill patients in the ICU? Study design Multi-center Double blinded RCT Population Characteristics of study participants 39.0% female N = 5037 61.0% male 5037 patients (1948 female, 3089 male) Inclusion criteria: critically ill patients Key exclusion criteria: specific fluid requirements; receipt of > 500 mL of fluid resuscitation; imminent risk of death or a preexisting life expectancy < 90 days; TBI or at risk for cerebral edema Interventions N=2515 balanced multielectrolyte solution (Plasma-Lyte 148 for up to 90 days) N=2522 saline solution (0.9% sodium chloride) Primary outcome Death from any cause at day 90 22.0 % 22 21.8 16.5 % 11.0 % 5.5 % No significant difference 0.0 % https://web.pathway.md/studies/recRNCoqU7hX8yEh1 1/2 6/29/23, 1:38 AM PLUS Pathway Balanced multielectrolyte solution Saline solution No significant difference in death from any cause at day 90 (21.8% vs. 22%; OR 0.99, 99% CI 0.86 to 1.14) Secondary outcomes No significant difference in the percentage of patients who received new renal-replacement therapy (12.7% vs. 12.9%; OR 0.98, 95% CI 0.83 to 1.16) No significant difference in maximum elevation in serum creatinine level (0.41 mg/dL vs. 0.41 mg/dL; AD 0.01 mg/dL, 95% CI -0.05 to 0.06) No significant difference in days alive without mechanical ventilation (68.3 days vs. 68.2 days; AD 0.06 days, 95% CI -1.79 to 1.91) Safety outcomes No significant difference in adverse and serious adverse events. Conclusion In critically ill patients, balanced multielectrolyte solution was not superior to saline solution with respect to death from any cause at day 90. Reference Simon Finfer, Sharon Micallef, Naomi Hammond et al. Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults. N Engl J Med. 2022 Mar 3;386(9):815-826. Open reference URL https://web.pathway.md/studies/recRNCoqU7hX8yEh1 2/2