Saline Versus Balanced Crystalloids for Intravenous Fluid Therapy in the Emergency Department: Study Protocol for a Cluster-Randomized, Multiple-Crossover Trial

Prior studies in critically ill patients suggest the supra-physiologic chloride concentration of 0.9% (“normal”) saline may be associated with higher risk of renal failure and death compared to physiologically balanced crystalloids. However, the comparative effects of 0.9% saline and balanced fluids are largely unexamined among patients outside the intensive care unit, who represent the vast majority of patients treated with intravenous fluids.