Background Fluid excess may place patients undergoing surgery at risk for various complications. Hypertonic saline (HS) maintains intravascular volume with less intravenous fluid than isotonic salt (IS) solutions, but may increase serum sodium. Objectives To determine the benefits and harms of HS versus IS solutions administered to patients undergoing surgery.

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A new author has been added to the review team (Brad Shrum). We added three new studies which did not change the conclusions of the review. We updated the methods for the review.

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Background Fluid excess may place patients undergoing surgery at risk for various complications. Hypertonic saline (HS) maintains intravascular volume with less intravenous fluid than isotonic salt (IS) solutions, but may increase serum sodium. Objectives To determine the benefits and harms of HS versus IS solutions administered to patients undergoing surgery.