Publication: Balanced salt solution versus normal saline solution as initial fluid resuscitation in pediatric septic shock: A randomized, double-blind controlled trial
Issued Date
2020-01-01
Resource Type
ISSN
14107767
Other identifier(s)
2-s2.0-85089623958
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Critical Care and Shock. Vol.23, No.4 (2020), 158-168
Suggested Citation
Nattachai Anantasit, Sriwanna Thasanthiah, Rojjanee Lertbunrian Balanced salt solution versus normal saline solution as initial fluid resuscitation in pediatric septic shock: A randomized, double-blind controlled trial. Critical Care and Shock. Vol.23, No.4 (2020), 158-168. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/59267
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Balanced salt solution versus normal saline solution as initial fluid resuscitation in pediatric septic shock: A randomized, double-blind controlled trial
Other Contributor(s)
Abstract
© 2020, The Indonesian Foundation of Critical Care Medicine. All rights reserved. Objective: Initial fluid resuscitation is mandato-ry in treatment of septic shock. Current sepsis guidelines do not have the recommendation for either balanced salt or normal saline solution for initial fluid resuscitation. The objective of this study was to determine the impact of balanced salt solution (BS) versus normal saline solution (NS) in pediatric septic shock as initial fluid resuscitation. Design: A double-blind randomized controlled trial study. Setting: A single tertiary care center in Bang-kok, Thailand. Patients and participants: Children aged 1 month to 18 years who were diagnosed with septic shock. We excluded patients who received fluid resuscitation in the 24 hours prior to septic shock, end-stage disease, and refusal of in-formed consent. Interventions: Patients were randomly assigned into 2 groups after being diagnosed with septic shock and required fluid resuscitation (NS or BS). Measurements and results: Demographic data, vasoactive-inotropic scores, and outcomes were evaluated. The primary outcome was incidence of hyperchloremic metabolic acidosis. Sixty-one septic shock children were enrolled into this study (NS=31 patients, and BS=30 patients). Baseline characteristics between two groups were not different. The incidence of hyperchlor-emic metabolic acidosis was 17 (54.8%) and 10 (33.3%) in NS and BS groups, respectively (p=0.091). The hospital mortality and preva-lence of acute kidney injury were not different between groups. Conclusion: In pediatric septic shock, the initial fluid resuscitation with balanced salt solution and normal saline was associated with similar clinical outcomes. However, normal saline solution had a trend toward more frequent hyper-chloremic metabolic acidosis in children with septic shock when compared to balanced salt solution.