TABLE 2.
Summary of findings table. Evaluation of the quality of evidence according to Grading of Recommendations Assessment, Development, and Evaluation (GRADE)
| Certainty assessment | № of patients | Effect | Certainty | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Acetate‐buffered crystalloid solutions | Lactate‐buffered crystalloid solutions | Relative (95% CI) | Absolute (95% CI) | ||
| All‐cause short‐term mortality ≤ 90 days | ||||||||||||
| 4 | Randomised trials | Not serious a | Serious b , c | Not serious | Very serious d | None | 0/144 (0.0%) | 6/142 (4.2%) | RR 0.15 (0.02 to 1.15) | 36 fewer per 1.000 (from 41 fewer to 6 more) |
⨁◯◯◯ Very low |
Critical |
| All‐cause long‐term mortality >90 days—not reported | ||||||||||||
| – | – | – | – | – | – | – | – | – | – | – | – | Critical |
| Adverse events—not reported | ||||||||||||
| – | – | – | – | – | – | – | – | – | – | – | – | Critical |
| Health related quality of life (any scale)—not reported | ||||||||||||
| – | – | – | – | – | – | – | – | – | – | – | – | Critical |
| Hospital length of stay (assessed with: days) | ||||||||||||
| 2 | Randomised trials | Not serious a | Serious c | Not serious | Very serious e | None | 182 | 180 | – | MD 1.31 days lower (3.66 lower to 1.05 higher) |
⨁◯◯◯ Very low |
Important |
| ICU length of stay (assessed with days) | ||||||||||||
| 3 | Randomised trials | Not serious a | Serious b , c | Not serious | Very serious d | None | 114 | 112 | – | Not pooled | ⨁◯◯◯Very low | Important |
| Duration of mechanical ventilation (MV)—not reported | ||||||||||||
| – | – | – | – | – | – | – | – | – | – | – | – | Important |
| Duration of renal replacement therapy (RRT)—not reported | ||||||||||||
| – | – | – | – | – | – | – | – | – | – | – | – | Important |
| Duration of vasopressor/inotropics | ||||||||||||
| 1 | Randomised trials | Not serious a | Not serious | Not serious | Very serious f | None | 75 | 73 | – | 0 (0–0) |
⨁⨁◯◯ Low |
Important |
Abbreviations: CI, confidence interval; MD, mean difference; RR, risk ratio.
Trials were judged as overall ‘low’ risk of bias or ‘some concerns’ (unclear risk of bias). Potential limitations are unlikely to lower confidence in the estimate of effect.
Inconsistency downgraded because of differences in population.
Inconsistency downgraded because of difference in interventions (e.g. one trial applied fluids as pump prime during CABG and one trial used fluids as resuscitation therapy in critically ill burn patients).
TSA could not be performed because <5% of the required information size had been reached.
TSA revealed that only 7% of the required information size had been accrued.
Duration of vasopressor was reported by only 1 trial (n = 150).