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The efficacy and safety of normal saline (NS) for fluid therapy in critically ill patients remain controversy.In this review,we summarized the evidence of randomized controlled trials (RCTs) which compared NS with other solutions in critically ill patients.The results showed that when compared with 6% hydroxyethyl starch (HES),NS may reduce the onset of acute kidney injury (AKI).However,there is no significant different in mortality and incidence of AKI when compared with 10% HES,albumin and buffered crystalloid solution.Therefore,it is important to prescribe intravenous fluid for patients according to their individual condition.