Evidence · Systematic review or meta-analysis
Balanced crystalloid versus saline for resuscitation in pediatric septic shock: a systematic review and meta-analysis.
- Acute kidney injury
- Cardiovascular
- Fluids and electrolytes
- Infection and sepsis
- Medical
- Nursing
- Renal and metabolic
- Renal replacement therapy
- Sepsis
- Shock
Summary
Systematic review and meta-analysis of 8 studies (4 RCTs, >12,000 children) comparing balanced crystalloids with normal saline for fluid resuscitation in paediatric sepsis and septic shock. Outcomes assessed included AKI, mortality, mechanical ventilation, renal replacement therapy, hyperchloraemia, and hospital and PICU length of stay. Balanced solutions were associated with less hyperchloraemia and, in the RCT subgroup, less need for renal replacement therapy, while hospital length of stay was longer; mortality and AKI did not differ significantly. Relevant to PICU teams making fluid choices in septic shock, with the authors noting continued uncertainty and need for further trials.
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- Open (Creative Commons)
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