6/29/23, 11:41 PM SALT-ED Pathway Feedback Search Clinical Topics Home Studies SALT ED SALT ED Trial question What is the effect of balanced crystalloids in noncritically ill patients treated with intravenous fluids in the emergency department? Study design Single center Open label RCT Population Characteristics of study participants 52.0% female N = 13347 48.0% male 13347 patients (6886 female, 6461 male) Inclusion criteria: noncritically ill patients who were treated with intravenous crystalloids in the emergency department and were subsequently hospitalized outside an ICU Key exclusion criteria: receipt of < 500 ml of crystalloids in the emergency department, age < 18 years, discharge from emergency department Interventions N=6708 balanced crystalloids (infusion of lactated Ringer's solution or Plasma-Lyte A) N=6639 normal saline (infusion of 0.9% saline) Primary outcome Hospital-free days 25.0 days 25 25 18.8 days 12.5 days 6.3 days https://web.pathway.md/studies/reckVfswV33qSNQS6 1/2 6/29/23, 11:41 PM SALT-ED Pathway No significant difference 0.0 days Balanced crystalloids Normal saline No significant difference in hospital-free days (25 days vs. 25 days; OR 0.98, 95% CI 0.92 to 1.04) Secondary outcomes Significant decrease in the rate of major adverse kidney events within 30 days (4.7% vs. 5.6%; OR 0.82, 95% CI 0.7 to 0.95) No significant difference in stage 2 or higher AKI (8% vs. 8.6%; OR 0.91, 95% CI 0.8 to 1.03) No significant difference in death in the hospital (1.4% vs. 1.6%; OR 0.88, 95% CI 0.66 to 1.16) Safety outcomes No significant differences in death, new RRT, final serum creatinine 200% of baseline. Conclusion In noncritically ill patients who were treated with intravenous crystalloids in the emergency department and were subsequently hospitalized outside an ICU, balanced crystalloids were not superior to normal saline with respect to a hospital-free days. Reference Self WH, Semler MW, Wanderer JP et al. Balanced Crystalloids versus Saline in Noncritically Ill Adults. N Engl J Med. 2018 Mar 1;378(9):819-828. Open reference URL https://web.pathway.md/studies/reckVfswV33qSNQS6 2/2