In patient with a sickle cell crisis, which IV fluid is best?Normal saline versus lactated ringers
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- Answered 5 Feb 2020 Conflict of interest declaration: None I may be missing something but a search on PubMed for "Ringer's lactate solution AND sickle cell" finds only one article  A 2017 Cochrane review "Fluid replacement therapy for acute episodes of pain in people with sickle cell disease"  concludes: "Treating vaso‐occlusive crises is complex and requires multiple interventions. Extra fluids, generally oral or intravenous, are routinely administered during acute painful episodes to people with sickle cell disease regardless of the individual's state of hydration. Reports of their use during these acute painful episodes do not state the efficacy of any single route, type or quantity of fluid compared to another. However, there are no randomised controlled trials that have assessed the safety and efficacy of different routes, types or quantities of fluid. This systematic review identifies the need for a multicentre randomised controlled trial assessing the efficacy and possible adverse effects of different routes, types and quantities of fluid administered to people with sickle cell disease during acute painful episodes." Which highlights a lack of trials! References 1) https://pubmed.ncbi.nlm.nih.gov/?term=Ringer%27s+lactate+solution+AND+sickle+cell 2) https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005406.pub5/full