The N of the trial speaks to its quality and power, but a power calculation is more than just effect size. Besides, a NNT for MAKE30 of 83 is a decent effect size--I think practice-changing, even from a cost-analysis point of view (LR is about $5 a litre over here, peanuts compared to an extra few hospital days). This signal has been demonstrated many times before, but old habits die hard. (
@SurfingDoctor, it wasn't that long ago we used to give hypotonic maintenance fluids to kids.)
Here was the study that caught my eye a few years ago from Melbourne with a similar conclusion. It's
not about hyperchloraemic acidosis per se but chloride itself.
@Nephro critical care, I'd be interested if you have any thoughts.
Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M. Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults. JAMA. 2012;308(15):1566-72.
Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults. - PubMed - NCBI