PAS: Balanced Crystalloid Fluid, 0.9 Percent Saline Comparable in Pediatric Septic Shock

WEDNESDAY, April 29, 2026 (HealthDay News) -- For children treated for suspected septic shock, the incidence of death, new renal-replacement therapy, or persistent kidney dysfunction is similar with fluid resuscitation administered with balanced crystalloid fluid or 0.9 percent saline, according to a study published online April 23 in the New England Journal of Medicine to coincide with the annual meeting of the Pediatric Academic Societies, being held April 24 to 27 in Boston.Fran Balamuth, M.D., Ph.D., from the Children's Hospital of Philadelphia, and colleagues conducted a pragmatic clinical trial at 47 emergency departments in five countries involving children aged 2 months to <18 years of age with suspected septic shock and abnormal perfusion. Participants were randomly assigned to receive fluid resuscitation with either balanced fluid or 0.9 percent saline for up to 48 hours (4,235 and 4,247 patients, respectively, were included in the analysis). The primary outcome was a major adverse kidney event (composite of death, new renal-replacement therapy, or persistent kidney dysfunction) at 30 days after enrollment or hospital discharge.The researchers found that a primary outcome event occurred in 3.4 and 3.0 percent of patients in the groups receiving balanced fluid and 0.9 percent saline, respectively. During the 28 days after enrollment, the median number of hospital-free days was 23 in both groups. Hyperchloremia occurred in 31.4 and 49.0 percent of patients in the groups receiving balanced fluid and 0.9 percent saline, respectively; hypernatremia occurred in 1.8 and 3.1 percent, respectively; and hyperlactatemia occurred in 19.8 and 16.7 percent, respectively. There were no differences seen in other safety outcomes or adverse events."In an emergency department with a child with suspected sepsis, you can treat the child with whichever fluid is readily available," Balamuth said in a statement. "And we think that's great news for children around the world."Several authors disclosed ties to the biopharmaceutical industry.Abstract/Full Text (subscription or payment may be required)More Information.Sign up for our weekly HealthDay newsletter

PAS: Balanced Crystalloid Fluid, 0.9 Percent Saline Comparable in Pediatric Septic Shock

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