TABLE 1.

Trial characteristics

Study/year	Country	Single/multicentre trial (no. of sites)	No. of patients	Clinical setting	Population	Exclusion criteria	Acetate‐buffered solution (no. randomised)	Lactate‐buffered solution (no. randomised)	Patient‐important outcomes
Chaussard et al/2020 22	France	Single	28	Tertiary Burn ICU	Patients >18 years, with burns (>30% TBSA)	Pregnancy, refusal to participate and do not resuscitate orders	Plasmalyte (n = 14)	Ringers Lactate (n = 14)	28‐day mortality and ICU length of stay
Pfortmüller et al/2019 23	Switzerland	Single	150	Surgery and ICU	Patients 18–80 years, undergoing elective open cardiac surgery	<18 years or >80 years. Pre‐existing impaired cardiac or renal function, anaemia, chronic inflammatory‐ or liver disease. Long term steroid medication, active infection, emergency‐ or redo surgery and isolated CABG surgery. Planned use of minimal extracorporeal circuits, early extubation protocols or restrictions to full therapy	Ringers Acetate (n = 75)	Ringers Lactate (n = 75)	In‐hospital mortality, hospital length of stay, ICU length of stay and duration of inotropic /vasopressor treatment
Weinberg et al/2018 24	Australia	Single	50	Surgery	Adults undergoing elective primary CABG or valve surgery	Requirement of Custodial® HTK cardioplegia solution, pregnancy, abnormal plasma bicarbonate concentration, hypercapnic respiratory failure, chronic renal‐ or liver disease, diabetes, anaemia or morbid obesity	Plasmalyte‐148 (n = 25)	Hartmann's solution (n = 25)	In‐hospital mortality, hospital length of stay and ICU length of stay
Weinberg et al/2015 25	Australia	Multi (4)	60	Surgery	Adult patients, undergoing elective open major liver resection	<18 years, laparoscopic or minimally invasive surgery, hepatic‐ or renal impairment, preoperative coagulopathy, and ASA score 4 or 5	Plasmalyte‐148 (n = 30)	Hartmann's solution (n = 30)	30‐day mortality, hospital length of stay and ICU length of stay
Shin et al/2011 26	Korea	Single	104	Surgery	Living liver donors undergoing scheduled right hepatectomy	>40 years, emergency donors, left hepatectomy, had >30% fatty change	Plasmalyte (n = 52)	Ringers Lactate (n = 52)	Post‐operative hospital stay
Semler MW/Ongoing trial (NCT03537898)	USA	Single	Expected 2093	Medical ICU	Patients ≥18 years admitted to the Medical ICU	Prisoners	Normosol	Ringers Lactate	30‐day in‐hospital mortality, renal replacement therapy‐free days, vasopressor‐free days, ventilator‐free days, intensive care unit‐free days
Weiss S/Ongoing trial (NCT04102371)	USA	Multi (30+)	Expected 8800	Paediatric dept. and ED's receiving paediatric patients	Patients >6 months to <18 years with suspected sepsis who received <40 ml/kg IV/IO total crystalloid fluid prior to randomisation	Hyperkalaemia, hypercalcemia, hepatic‐ or renal impairment, metabolic disorder, impending brain herniation, pregnancy or known allergy to study fluids. prisoners	Plasmalyte	Ringers Lactate	All‐cause 90‐day mortality
Raman S/Ongoing trial 38	Australia	Single	Expected 480	Paediatric ICU	Patients age from birth to <16 years admitted to PICU within the last 24 h and received IVFT for ≤4 h in PICU. All fluids must have been administered in PICU. Patients sodium level >130 mmol/L	Age >16 years, received IVFT for >4 h in PICU or admitted for cardiac condition or chronic kidney disease. Patients with Traumatic brain injury, burns, post‐liver transplant, post‐renal transplant, ketoacidosis, major electrolyte abnormalities or oncologic patients in need of rehydration	Plasmalyte	Compound sodium lactate	Organ dysfunction free survival, PICU LOS, hospital LOS, PICU free survival and adverse event

Abbreviations: ASA, American Society of Anaesthesiology score; CABG, coronary artery bypass grafting; ED, emergency department; ICU, intensive care unit; IO, intraosseous; IV, intravenous; IVFT, intravenous fluid therapy; PICU, paediatric intensive care unit; TBSA, total burn surface area.