CHICAGO — A randomized clinical trial found no difference in outcomes between balanced crystalloid fluid and 0.9% saline for treating septic shock in children. The results of the trial were published in the New England Journal of Medicine.
Over 9,000 children, aged 2 months to less than 18 years, with suspected septic shock were enrolled in the study. The trial was conducted across five countries in 47 pediatric emergency departments, including the Ann & Robert H. Lurie Children's Hospital of Chicago.
Elizabeth Alpern, Professor of Pediatrics, stated that no additional benefit or harm was found when using one type of IV fluid over another. "We found no difference in outcomes, such as major adverse kidney event or persistent kidney dysfunction at 30 days," Alpern said.
Septic shock is a medical emergency where an extreme response to infection leads to organ failure. Previous smaller studies had shown mixed results regarding the comparative renal benefits of balanced crystalloid fluid and 0.9% saline.
Researchers engaged community members, patient families, and advisory boards for input during the study's development phase. This engagement was because standard informed consent is not always feasible in emergency situations. Families were also able to opt out of the study in advance.
She serves as the Division Head of Emergency Medicine at Lurie Children's Hospital and as a Professor of Pediatrics at Northwestern University Feinberg School of Medicine. She holds the George M. Eisenberg Professorship in Pediatrics. She said, "Now we can move on from the debate about what kind of fluid is best and focus on new ways to improve care for kids with septic shock."
No independent assessment of Elizabeth Alpern’s claims was available.