Effects of chloride content of intravenous crystalloid solutions in critically ill adult patients: a meta-analysis with trial sequential analysis of randomized trials

Xue, Ming; Zhang, Xiwen; Liu, Feng; Chang, Wei; Xie, Jianfeng; Xu, Jingyuan; Yang, Yi; Qiu, Haibo

doi:10.1186/s13613-019-0506-y

Annals of Intensive Care

Table 3 Effects of chloride content of intravenous crystalloid solutions on in-hospital mortality by subgroups

From: Effects of chloride content of intravenous crystalloid solutions in critically ill adult patients: a meta-analysis with trial sequential analysis of randomized trials

Subgroups	No. of studies	No. of patients	RR (M–H, random, 95% CI)	p value	I² (%)
Crystalloid fluid type
LR [20,21,22]	3	150	1.00 [0.07, 15.33]	1.00	NA
Plasma-Lyte [9, 23, 24]	3	2375	0.91 [0.70, 1.19]	0.50	0
Mixed of LR and Plasma-Lyte [10, 25]	2	16776	0.93 [0.85, 1.01]	0.08	0
Test for subgroup differences: χ² = 0.01, df = 2 (p = 0.99)
Crystalloid fluid volume
Median or mean volume more than 5L [20, 21, 23]	3	142	0.86 [0.25, 2.94]	0.80	0
Median or mean volume less than 5L [9, 10, 24, 25]	4	19105	0.92 [0.85,1.00]	0.06	0
Unclear [22]	1	54	NA	NA	NA
Test for subgroup differences: χ² = 0.01, df = 1 (p = 0.90)
Setting
ICU [9, 10, 22,23,24,25]	6	19205	0.92 [0.85,1.00]	0.06	0
Transferred to ICU in perioperative period [20, 21]	2	96	1.00 [0.07, 15.33]	1.0	NA
Test for subgroup differences: χ² = 0.00, df = 1 (p = 0.95)
Specific patients
Sepsis
Yes [9, 10]	2	2420	0.86 [0.75, 0.98]	0.02	0
No [9, 10, 20,21,22]	5	15794	0.96 [0.86, 1.07]	0.48	0
Classification not mentioned [23,24,25]	3	1087	0.95 [0.66, 1.37]	0.79	0
Test for subgroup differences: χ² = 1.8, df = 2 (p = 0.41)
TBI
Yes [9, 10]	2	1420	1.11 [0.86, 1.43]	0.43	0
No [9, 10, 20,21,22]	5	16794	0.90 [0.82, 0.99]	0.02	0
Classification not mentioned [23,24,25]	3	1087	0.95 [0.66, 1.37]	0.79	0
Test for subgroup differences: χ² = 2.31, df = 2 (p = 0.32)
Risk of bias
High [10, 23, 25]	3	16822	0.92 [0.85, 1.01]	0.98	0
Low [9, 20, 22, 24]	4	2449	0.91 [0.69, 1.20]	0.42	0
Unclear [21]	1	30	NA	NA	NA
Test for subgroup differences: χ² = 0.01, df = 1 (p = 0.93)
Including sample size (in each group)
Over 1000 [9, 10]	2	18064	0.92 [0.85, 1.00]	0.06	0
Equal or less than 1000 [20,21,22,23,24,25]	6	1237	0.95 [0.71, 1.28]	0.75	0
Test for subgroup differences: χ² = 0.05, df = 1 (p = 0.82)

The random-effects model was applied above
No. number, RR risk ratio, CI confident interval, NA not applicable, ICU intensive care unit, TBI traumatic brain injury

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