Plasma-Lyte 148® or 0.9% saline for all resuscitation episodes and compatible crystalloid therapy whilst in ICU, from the first episode of fluid resuscitation (randomisation) for up to 90 days. 

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Inclusion criteria

Patients >18 yrs, who require fluid resuscitation AND at least one of seven pre-specified clinical signs:

HR > 90 bpm;
SBP < 100 mmHg; 
MAP < 75 mmHg; 
CVP < 10 mmHg; 
PAWP < 12 mmHg;
cap refill time > 1 sec;
UOP < 0.5 ml/kg for at least one hour

AND
 
Expected to remain in ICU and not be eating today or tomorrow

AND

have an arterial or central venous catheter in situ, or placement is imminent as part of routine management.

Exclusion criteria

If study treatment is contraindicated; 
OR, 
Admitted to the ICU with specific fluid requirements:
the treatment of burns;
following liver transplantation surgery;
for correction of specific electrolyte abnormalities;
traumatic brain injury;
OR,
those considered at risk of developing cerebral oedema;
OR,
​death is imminent or 90 days survival is  unlikely.