Pediatric anesthesia & critical care
Multiple Electrolytes Solution Versus Saline as Bolus Fluid for Resuscitation in Pediatric Septic Shock: A Multicenter Randomized Clinical Trial*
Primary resultResult — go to the resultRelative risk 0.62 95% CI 0.49–0.80Authors' conclusion
Among children presenting with septic shock, fluid resuscitation with MES (balanced crystalloid) as compared with 0.9% saline resulted in a significantly lower incidence of new and/or progressive AKI during the first 7 days of hospitalization.
Study context
- Population
- Children up to 15 years with septic shock, PICUs of four tertiary care centres in India, 2017–2020
- Participants
- 351 vs 357
- Comparison
- MES vs 0.9% saline
- MESn = 351
- 0.9% salinen = 357reference
- Primary endpoint
- New and/or progressive acute kidney injury (AKI)
- Follow-up
- Within the first 7 days of fluid resuscitation
Methodological detailsparallel-group, blinded, multicentre
- Parallel-group
- Blinded
- Multicentre
Primary result
As reported in the abstract
Relative risk
0.62
95% CI 0.49–0.80
P < 0.001
By group
MES vs Saline
RR 0.62 (95% CI 0.49–0.80); P < 0.001
Secondary outcomes
- All-cause ICU mortality — MES
- 33%
- All-cause ICU mortality: Saline 34%
Hyperchloremia · 24, 48, and 72 hours
- Lower proportions in MES vs saline at 24, 48 and 72 hours
All-cause ICU mortality
- No difference in ICU mortality
Safety
Infusion-related adverse event (AEs) (fever, thrombophlebitis, fluid overload)
- No difference between the groups
Original publication
Multiple Electrolytes Solution Versus Saline as Bolus Fluid for Resuscitation in Pediatric Septic Shock: A Multicenter Randomized Clinical Trial*. Crit Care Med. Published 9 June 2023. doi:10.
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