Large study compares pediatric septic shock treatments, finding both safe

A recent, large clinical trial analyzed two standard pediatric septic shock treatments, hoping to determine which is more beneficial. Key findings are reported in a National Institutes of Health (NIH) press release.

The NIH supported the research. More than 9,000 diverse pediatric patients from five countries participated. About half received balanced crystalloid fluid, while the other half received a 0.9% saline IV solution.

Key observations:

• No notable differences between the treatments were reported.
• Both groups experienced “a median of 23 hospital-free days during the 28 days following enrollment.”
• The 0.9% saline solution group faced more occurrences of abnormally high levels of chloride and sodium in the blood, but patient outcomes were not affected.
• The balanced crystalloid fluid group faced more occurrences of abnormally high lactate in the blood, but patient outcomes were not affected.

It is important to note that all participants had community-acquired sepsis and “presented to an emergency department in high-resource locations.” Additionally, “the authors cannot exclude the possibility that a specific fluid type could be preferred among the sickest subset of children or those who require treatment with very high fluid volumes.” Both treatments were validated for pediatric septic shock patients.