Balanced Fluids or Normal Saline for Pediatric Septic Shock

Clinicians have long debated the ideal resuscitation fluid for adult patients, and the choice is even less clear for children. In the largest pediatric trial on this issue to date, researchers randomized 9000 children with suspected septic shock to resuscitation with normal saline or balanced fluids; the type (mostly lactated Ringer’s or Hartmann’s solution) and volume of balanced fluid administered were left to the treating clinician.

The median age was 7 years, and the most common source of sepsis was respiratory. Coexisting conditions were similar between groups, and 24% of patients had acute kidney injury at enrollment. Total fluid volume administered was similar between groups.