Editorial  |   April 2020
Intravenous Fluids: Which Recipe?
Author Notes
  • From the Centre for Integrated Critical Care, Melbourne Medical School, The University of Melbourne, and Melbourne Academic Centre for Health (MACH), Melbourne, Australia.
  • This editorial accompanies the article on page 614. This editorial has a related Infographic on p. 19A.
    This editorial accompanies the article on page 614. This editorial has a related Infographic on p. 19A.×
  • Accepted for publication December 20, 2019. Published online first on February 11, 2020.
    Accepted for publication December 20, 2019. Published online first on February 11, 2020.×
  • Address correspondence to Dr. Story: dastory@unimelb.edu.au
Article Information
Editorial / Cardiovascular Anesthesia / Renal and Urinary Systems / Electrolyte Balance
Editorial   |   April 2020
Intravenous Fluids: Which Recipe?
Anesthesiology 4 2020, Vol.132, 609-611. doi:https://doi.org/10.1097/ALN.0000000000003161
Anesthesiology 4 2020, Vol.132, 609-611. doi:https://doi.org/10.1097/ALN.0000000000003161
In this edition of Anesthesiology, Maheshwari et al.1  report on the Saline or Lactated Ringer’s (SOLAR) trial, conducted at the Cleveland Clinic in the United States. The researchers tested the hypothesis that among more than 8,000 patients undergoing elective colorectal and orthopedic surgery, a composite outcome of in-hospital mortality and major postoperative complications would be less common among those given lactated Ringer’s solution than patients given normal saline during surgery. However, contrary to the hypothesis, the researchers found that there was no important difference in postoperative complications between the two fluid groups. Further, there was no important difference in acute kidney injury. The authors concluded: “Clinicians can reasonably use either fluid for routine vascular volume replacement in patients having noncardiac surgery.” So, can we now safely give saline to all noncardiac surgical patients, particularly higher-risk patients? As often happens with clinical questions, the devil is in the detail.