Each time I come across another article on this topic, I tell myself it will be the last time I read one — yet somehow, I keep coming back. The ongoing debate over whether lactated Ringer’s (LR) is better than normal saline (NS), or vice versa, seems endless.
The recent NEJM article concluded that there was no significantly lower incidence of death or readmission within 90 days after the index admission, regardless of fluid type. As always, there are numerous confounders and contributing factors that influence outcomes in critically ill patients.
In my view, rather than focusing so heavily on which fluid is “best,” we should emphasize critical actions and timely interventions that truly impact patient outcomes. I know this perspective can be provocative and will certainly spark heated debate, but I believe it is an important discussion to have.