In the News: Is Normal Saline good enough?

A recently published study in JAMA evaluated prospectively normal saline (chloride based) to non chloride based fluids in the ICU setting. The outcome was to evaluate the precipitation of AKI.
Interestingly, a LR type solution was the opposite counterpart.  While there was no difference in mortality, ICU stay and hospital stay or even the need for dialysis after discharge, the chloride based solution had a higher incidence of AKI and need for in-hospital dialysis.  This study might be a tradition changer for many "internal medicine" physicians as we have traditionally argued with the surgical colleagues regarding use of " LR vs. Normal Saline" in almost all circumstances. An editorial with this also takes us through a historical perspective.