Lactated Ringer Solution Better Than Normal Saline for Sickle Cell Pain Crises
By Lori Solomon HealthDay Reporter
TUESDAY, Sept. 17, 2024 -- Administration of lactated Ringer (LR) solution has a small but significant improvement on sickle cell disease outcomes versus normal saline (NS) for fluid resuscitation during pain crises, according to a study published online Sept. 9 in JAMA Internal Medicine.
Augusta K. Alwang, M.D., from Boston University, and colleagues compared the effectiveness of LR solution versus NS for fluid resuscitation in patients with sickle cell disease and vaso-occlusive episodes. The analysis included data from 3,495 patient encounters where LR was administered and 52,079 where NS was administered on hospital day 1.
The researchers found that patients who received LR had more hospital-free days (HFDs) at 30 days compared with those who received NS (marginal mean difference, 0.4 days). Further, patients who received LR also had shorter hospital lengths of stay (marginal mean difference, −0.4 days) and a lower risk for 30-day readmission (marginal risk difference, −5.8 percent). However, differences in HFDs between the two groups were heterogenous based on fluid volume received. For patients who received <2 L, there was no difference in LR versus NS, but among those who received ≥2 L, LR was superior to NS.
"Currently, patients with sickle cell disease who are admitted to the hospital for vaso-occlusive pain episodes usually receive normal saline, and clinical decision support tools presently recommend normal saline," coauthor Nicholas Bosch, M.D., also from Boston University, said in a statement. "However, our results call these recommendations and current practice into question."
Several authors disclosed ties to industry.
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Posted September 2024
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