This meta-analysis contributes very little to the current discussion mainly because of the heterogeneity of included studies. The use of fluid type in different pathologies isn’t really what we need, but rather tailored use of fluids with patient-oriented outcomes. It appears the debate over balanced crystalloids and normal saline in the resuscitation of the critically ill will continue. Although it makes more physiological sense to use balanced crystalloids in large volume (>2L) resuscitation, at this point in time it appears if you are using NS or a balanced crystalloid as your resuscitation fluid of choice keep using your fluid of choice, and don’t worry about changing your practice, although some individual studies have shown advantages in some clinical situations, until more robust evidence pushes you to do so.

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