Please select the eligibility criteria that correspond to the clinical trial below.
Title: Isotonic Solution Administration Logistical Testing: Pilot Study for the Isotonic Solutions and Major Adverse Renal Events Trial
Brief Summary: The administration of intravenous crystalloids is ubiquitous in the care of the critically ill. Commonly available crystalloid solutions contain a broad spectrum of electrolyte compositions including a range of chloride concentrations. Recent studies of associated higher fluid chloride content with acute kidney injury and mortality but no large, randomized trials have been conducted. In preparation for a large, cluster-randomized, multiple-crossover trial comparing 0.9% sodium chloride to physiologically-balanced isotonic crystalloids (Lactated Ringers or Plasmalyte-A) in intensive care unit patients, this pilot study will enroll all patients admitted to the medical intensive care unit at a single tertiary center for a sixth month period. The primary objective will be to test the ability of an electronic order entry tool to ensure administration of assigned study fluid or record contraindications to assigned study fluid. The pilot study will also demonstrate the feasibility of collecting demographic, severity of illness, fluid management, vital sign, laboratory, acute kidney injury and renal replacement therapy, and outcome data in an automated, electronic fashion.


Options:
A: Inclusion Criteria:

* Admitted to the adult medical intensive care unit (MICU) at Vanderbilt University Medical Center

Exclusion Criteria:

* Age\<18 years old
B: Inclusion Criteria:

* Emergency department patient
* Chief complaint of nausea, vomiting or emesis, diarrhea, abdominal pain, dehydration, heat stroke or exhaustion
* ED provider approves administration of two liters of fluid
* ED provider states patient is likely to be discharged
* Patient has followed up with PCP in the last two years
* Patient has access to phone for next two days following ED discharge

Exclusion Criteria:

* Prisoners
* Children
* Women known to be pregnant
* Jaundice
* Current chemotherapy
C: Inclusion Criteria:

* Glasgow \< or equal to 8
* Patient \> 18 years old

Exclusion Criteria:

* Polytraumatism
* Pregnancy
* Patient under guardianship
* renal insufficiency, hypokaliemia, hypocalcemia
D: Inclusion Criteria:

1. AGE (etiology: viral or other) resulting in presentation to the ED deemed in need of IV rehydration. In the 24 hours prior to presentation, the subject experienced at least 3 episodes of diarrhea (loose and/or watery stools) and/or nonbilious vomiting.
2. Moderate to severe dehydration (as assessed by Gorelick score13 ≥ 4
3. ≥ 6 months to \< 11 years of age.
4. Healthy except for the underlying etiology of AGE.
5. Institutional Review Board (IRB)/Independent Ethics Committee (IEC)-approved written ICFs and privacy language per national regulations (eg, Health Insurance Portability and Accountability Act \[HIPAA\], Personal Information Protection and Electronic Documents Act \[PIPEDA\]) were obtained from the parent/guardian prior to any study-related procedures.

Exclusion Criteria:

1. AGE that did not require IV rehydration per the clinician.
2. Gorelick score ≤ 3
3. Bilious vomiting.
4. Received \> 20 mL/kg IV fluid bolus within the 4 hours prior to study enrollment (ie, Hour -4 to Hour 0).
5. Diarrhea lasting \> 7 days prior to presentation to the ED.
6. Chronic vomiting disorder.
7. Grossly bloody diarrhea.
8. Chronic diarrheal disorder.
9. Known hyponatremia (sodium \< 130 mmol/L \[\< 130 mEq/L\]) within 72 hours prior to enrollment.
10. Known hypernatremia (sodium \> 155 mmol/L \[\> 155 mEq/L\]) within 72 hours prior to enrollment.
11. Known hypokalemia (potassium \< 3.0 mmol/L \[\< 3.0 mEq/L\]) within 72 hours prior to enrollment.
12. Known hyperkalemia (potassium \> 5.5 mmol/L \[\> 5.5 mEq/L\]) within 72 hours prior to enrollment.
13. The use of prohibited medications:

    * Antacids within 24 hours prior to presentation to the ED and during the study.
    * Anti-diarrhea medication within 24 hours prior to presentation to the ED and during the study.
    * The systemic use of corticosteroids/corticotropins was prohibited within 72 hours of enrollment.
14. Chronic health condition affecting the ability to tolerate fluids or those that result in electrolyte abnormalities (eg, chronic renal, cardiac, or pulmonary diagnoses), or abnormalities of sodium or potassium handling (eg, endocrine disorders, medications).
15. Any reason for urgent or emergency hospital admission or ED stays of \> 12 hours within 14 days preceding presentation to the ED.
16. Any medical condition likely to interfere with the subject's ability to fully complete all protocol-specified interventions, the ability to undergo all protocol-specified assessments, or likely to prolong the subject's need for medical attention beyond that required for treatment of dehydration.
17. Participation in a study of any investigational drug or device concomitantly or within 30 days prior to enrollment in this study, including previous enrollment in this study.
18. Subject with a \> 50% expected chance of dying within 6 months, in the Investigator's opinion.
19. Known hypersensitivity to either of the investigational products.
20. Other serious acute or active conditions that, in the Investigator's opinion, precluded participation in this study.

Answer: A