| Level I | Good quality evidence |
Systematic review of RCTs with consistent findings High quality individual RCT |
| Level II |
Limited quality patient orientated evidence |
Systematic review of lower quality studies or studies with inconsistent findings Low quality clinical trial Cohort studies Case-control studies |
| Level III | Other |
Consensus guidelines, extrapolations from bench research, usual practice, opinion, disease-oriented evidence (intermediate or physiologic outcomes only), or case series |
[30] Ringer Lactate, IV: National Department of Health: Affordable Medicines, EDP-Adult Hospital level. Medicine Review: Ringer Lactate for resuscitation in adults, updated review, August 2019. http://www.health.gov.za/
Ringer Lactate, IV: Antequera Martin AM, Barea Mendoza JA, Muriel A, Saez I, Chico-Fernandez M, Estrada-Lorenzo JM, et al. Buffered solutions versus 0.9% saline for resuscitation in critically ill adults and children. Cochrane Database Syst Rev. 2019 Jul 19;7:CD012247. https://www.ncbi.nlm.nih.gov/pubmed/31334842
Ringer Lactate, IV: Liu C, Lu G, Wang D, Lei Y, Mao Z, Hu P, Hu J, Liu R, Han D, Zhou F. Balanced crystalloids versus normal saline for fluid resuscitation in critically ill patients: A systematic review and meta-analysis with trial sequential analysis. Am J Emerg Med. 2019 Mar 1. pii: S0735-6757(19)30149-4. https://www.ncbi.nlm.nih.gov/pubmed/3085204
Ringer Lactate, IV: Brown RM, Wang L, Coston TD, Krishnan NI, Casey JD, Wanderer JP, Ehrenfeld JM, Byrne DW, Stollings JL, Siew ED, Bernard GR, Self WH, Rice TW, Semler MW; SMART Investigators and the Pragmatic Critical Care Research Group. Balanced Crystalloids Versus Saline in Sepsis: A Secondary Analysis of the SMART Trial. Am J Respir Crit Care Med. 2019 Aug 27. https://www.ncbi.nlm.nih.gov/pubmed/31454263
Ringer Lactate, IV: Rochwerg B, Alhazzani W, Sindi A, Heels-Ansdell D, Thabane L, Fox-Robichaud A, et al. Fluid resuscitation in sepsis: A systematic review and network meta-analysis. Ann Intern Med. 2014;161(5):347–55. https://www.ncbi.nlm.nih.gov/pubmed/250474