Among critically ill patients requiring fluid challenges, use of a balanced solution compared with 0.9% saline solution did not significantly reduce 90-day mortality.

The findings do not support the use of this balanced solution.

Among 11,052 patients who were randomized, 10,520 (95.2%) were available for the analysis.

There was no significant interaction between the 2 interventions.

Planned surgical admissions represented 48.4% of all patients.

Of all the patients, 60.6% had hypotension or vasopressor use and 44.3% required mechanical ventilation at enrollment.

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