Evidence · Randomised trial
0.9% saline versus Plasma-Lyte as initial fluid in children with diabetic ketoacidosis (SPinK trial): a double-blind randomized controlled trial.
- Acute kidney injury
- DKA
- Fluids and electrolytes
- Medical
- Nursing
- Renal and metabolic
This paper is from 2020, more than five years ago. Newer evidence may have been published since.
Summary
Double-blind randomised controlled trial in an Indian tertiary paediatric centre comparing 0.9% saline with Plasma-Lyte-A as the initial resuscitation and rehydration fluid in 66 children (1 month to 12 years) with diabetic ketoacidosis defined by ISPAD criteria. The primary outcome was new or progressive acute kidney injury, a composite of creatinine-based KDIGO and p-RIFLE criteria plus NGAL; secondary outcomes included time to DKA resolution, biochemical changes, need for renal replacement therapy, mortality and lengths of PICU and hospital stay. No significant differences were found between the balanced solution and saline for AKI incidence or resolution, or for any secondary outcome. Relevant to PICU teams managing DKA fluid choice, though the sample size was small and children with cerebral oedema or pre-referral fluids were excluded.
Summary written for PICUlearn. Always read the original.
- Licence:
- Open (Creative Commons)
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