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. 2024 Nov;28(11):1028-1037.
doi: 10.5005/jp-journals-10071-24825. Epub 2024 Oct 30.

Salt Based or BaLanced SolUtion-Trends Existing in Indian Intensive Care Units: A Multicenter Prospective Observational Cohort Study (SOLUTE Study)

Sachin Gupta  1 , Subhal Dixit  2 , Deeksha S Tomar  1 , Kapil Zirpe  3 , Deepak Govil  4 , Dhruva Choudhry  5 , Yatin Mehta  4 , Anand Gupta  6 , Lakkireddigari Siva Kumar Reddy  6 , Adarsh Singamsetty  6 , Sarala Kumari Daram  6 , Pooja R Murthy  7 , Kv Venkatesha Gupta  8 , Pratibha Dileep  9 , Kapildev Thakkar  10 , Sweta J Patel  4 , Divya Pal  4 , Naveen Paliwal  11 , Pooja Bihani  11 , Lakshmikanthcharan Saravana Bavan  12 , M N Sivakumar  12 , Sourabh S Ambapkar  2 , Saanvi S Ambapkar  2 , Yogendra Pal Singh  13 , Akhil Taneja  13 , Rajeeb K Mishra  14 , Suparna Bharadwaj  14 , Anuj Clerk  15 , Krunalkumar Patel  15 , Mehul Shah  16 , Zakariya Kaidawala  17
Affiliations

Salt Based or BaLanced SolUtion-Trends Existing in Indian Intensive Care Units: A Multicenter Prospective Observational Cohort Study (SOLUTE Study)

Sachin Gupta et al. Indian J Crit Care Med. 2024 Nov.

Abstract

Introduction: Fluid administration is a commonly practiced intervention in the intensive care unit (ICU) with normal saline being the preferred fluid. We sought to understand the current practice of fluid administration and choice of fluids in Indian ICUs and its effect on renal outcomes.

Materials and methods: The Indian Society of Critical Care Medicine (ISCCM)-endorsed multicenter prospective observational study was conducted on practice of fluid administration in critically ill patients between May 1, 2020, and January 31, 2023. SPSS software was used for statistical analysis.

Results: Private sector hospitals contributed 79.16% of data out of 144 ICUs. Around 961 patients belonged to the normal saline (NS) group, 672 to the Ringer's lactate (RL) group, and 891 to the balanced salt solution (BSS) group out of 2,452 patients. Patients with chronic obstructive pulmonary disease were more in the BSS and NS group as compared to RL group (p < 0.00001). Acute kidney injury (AKI) incidence was higher in the NS group, followed by RL and BSS (p < 0.0001). The serum creatinine rise was higher in the NS group on the first 2 days (p < 0.001). Daily fluid balance, urine output, and renal replacement therapy (RRT) needs were similar among the groups. The BSS group had shorter ICU and hospital length of stay (LOS) than the NS group (p < 0.001). The ICU survival was 63.3% in the NS group and 79.44% in the BSS group (p < 0.001). The AKI patients had higher survival in the BSS group (78.81%) as compared to the NS group (63.08%) (p < 0.001).

Conclusion: Balanced salt solution is the preferred intravenous fluid with a safe renal profile among critically ill patients. The AKI patients had shorter hospital and ICU LOS with BSS as compared to NS.

How to cite this article: Gupta S, Dixit S, Tomar DS, Zirpe K, Govil D, Choudhry D, et al. Salt Based or BaLanced SolUtion-Trends Existing in Indian Intensive Care Units: A Multicenter Prospective Observational Cohort Study (SOLUTE Study). Indian J Crit Care Med 2024;28(11):1028-1037.

Keywords: Acute kidney injury; Balanced salt solution; ICU length of stay; Normal saline.

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Conflict of interest statement

Source of support: The study was sponsored by the Indian Society of Critical Care Medicine and funded by Fresenius Kabi India Pvt Ltd. Conflict of interest: Dr Sachin Gupta, Kapil Zirpe, and Dr Deepak Govil are associated as the Editorial Board Members of this journal and this manuscript was subjected to this journal's standard review procedures, with this peer review handled independently of these Editorial Board Members and their research group.Conflict of interest: Dr Sachin Gupta, Kapil Zirpe, and Dr Deepak Govil are associated as the Editorial Board Members of this journal and this manuscript was subjected to this journal's standard review procedures, with this peer review handled independently of these Editorial Board Members and their research group.

Figures

Fig. 1
Fig. 1
Daily AKI incidence in various fluid subsets
Fig. 2
Fig. 2
Daily mean urine output on AKI days in various subsets
Fig. 3
Fig. 3
Daily mean serum creatinine in different fluid subgroups
Fig. 4
Fig. 4
Daily mean fluid balance and AKI in different fluid groups
Fig. 5
Fig. 5
ICU and hospital LOS
Fig. 6
Fig. 6
ICU and hospital survival
See this image and copyright information in PMC

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