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Letter to the Editor
SMART: Is saline on the tightrope?
SMART: ¿está el suero salino en la cuerda floja?
A. González-Castroa,
Corresponding author
e409@humv.es

Corresponding author.
, M. Ortiz-Lasaa, J. Bada Da Silvab
a Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
b Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Back in October 2015&#44; the results from the SPLIT trial<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> confirmed that the use of a balanced crystalloid solution as a resuscitation fluid in critically ill patients did not reduce the risk of developing acute renal failure compared to the use of a saline solution &#40;SS&#41;&#46; Contradicting important prior studies&#44;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> those conclusions complicated a fundamental debate&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Two years later&#44; October 2017&#44; the results from the SMART trial were published&#58; &#8220;Balanced crystalloids versus saline in the intensive care unit&#58; study protocol for a cluster-randomized&#44; multiple-crossover trial&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The SMART trial is a cluster-randomized&#44; multiple-crossover trial that was conducted between July 1&#44; 2015 and April 30&#44; 2017 in 5 American ICUs of one single university hospital&#46; Patients over 18&#44; who had been admitted to 5 selected ICUs &#40;medical&#44; surgical&#44; neurological&#44; trauma&#44; and cardiac&#41;&#44; and who had been prescribed one IV crystalloid solution were included in the study&#46; Same as the SPLIT trial&#44; the SMART trial compared to use of a SS to a balanced crystalloid solution&#46; The primary goal of the study was to determine the MAKE composite score &#40;Major Adverse Kidney Events&#58; intra-hospital death&#44; renal replacement therapy&#44; or renal dysfunction&#41; within the first 30 days after the ICU admission &#40;MAKE-30&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The results presented&#44; with 15&#44;802 patients recruited&#44; show that the outcome of MAKE-30 was present in 14&#46;3&#37; of patients from the group who received balanced SS compared to 15&#46;4&#37; of the patients from the second group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#44; with a 0&#46;91 adjusted odds ratio in favor of the balanced fluids &#40;95&#37; CI&#58; 0&#46;82&#8211;0&#46;99&#41;&#46; In this case&#44; the difference between the arms was triggered by the hospital mortality rate &#40;11&#46;1 versus 10&#46;3&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;06&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">These findings&#44; that are consistent with the different mortality rate seen in patients from the SPLIT trial &#40;7&#46;6 versus 8&#46;6&#37; in favor of the balanced solution&#41;&#44; cannot be considered a casual finding&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1&#44;5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">With the data presented from the SMART trial&#44; the number of patients needed to treat &#40;NNT&#41; to save just one life would be 94&#46; And even though this figure may be underestimated&#44; it is really important to think about the impact that such a routine daily measure as picking up this or that resuscitation fluid can have on the costs and human lives here at our ICUs&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Also&#44; balanced crystalloid solutions are more expensive&#46; However&#44; if we could use these fluids to avoid the occurrence of major adverse renal events&#44; we would definitely find it cost-effective to use them&#44; even if it wasn&#8217;t a short-term cost-effectiveness&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0040" class="elsevierStylePara elsevierViewall">Dr&#46; Gonz&#225;lez-Castro&#44; MD declares as a possible conflict of interest his job for Baxter&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">This manuscript has received no funding whatsoever&#46;</p></span></span>"
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                          "colaboracion" => "SPLIT Investigators&#59; ANZICS CTG"
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                            4 => "J&#46;P&#46; Wanderer"
                            5 => "J&#46;M&#46; Ehrenfeld"
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                        "tituloSerie" => "Chest"
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                        "paginaInicial" => "A1120"
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                      "titulo" => "The SPLIT trial&#58; anything new in critical care fluid therapy&#63;"
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ISSN: 21735727
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