pem pearl: LR vs ns in sickle cell disease
TLDR: Multicenter cohort study in adults showed that Lactated Ringers is better than Normal saline in fluid management for sickle cell vaso-occlusive episodes.
Details: 55,574 adult patients with SC pain crisis. 3495 received LR on hospital day 1, 52079 received NS on day 1. Those that received LR had less hospital visits and readmissions at 30 days, and had short length of stay by about ½ a day overall.
Thoughts: More sickling happens as blood pH decreases, so there has been an argument that LR makes more sense because it is more basic than NS. This study shows a modest improvement overall with LR use over NS. This should be repeated in peds and I would like to see some more data points. But, overall I think it bolsters the argument to use LR for sickle cell pain crisis.
Details: 55,574 adult patients with SC pain crisis. 3495 received LR on hospital day 1, 52079 received NS on day 1. Those that received LR had less hospital visits and readmissions at 30 days, and had short length of stay by about ½ a day overall.
Thoughts: More sickling happens as blood pH decreases, so there has been an argument that LR makes more sense because it is more basic than NS. This study shows a modest improvement overall with LR use over NS. This should be repeated in peds and I would like to see some more data points. But, overall I think it bolsters the argument to use LR for sickle cell pain crisis.
