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The debate over normal saline versus more balanced crystalloids for fluid resuscitation remains unresolved. This document outlines our recommendations for fluid choice during large volume fluid resuscitation in children.
Most Recent References
Resuscitation With Early Adrenaline Infusion for Children with Septic Shock: A Randomized Pilot Trial. Harley A, George S, Phillips N, King M, Long D, Keijzers G, Lister P, Raman S, Bellomo R, Gibbons K, Schlapbach LJ; Resuscitation in Paediatric Sepsis Randomized Controlled Pilot Platform Study in the Emergency Department (RESPOND ED) Study Group. Pediatr Crit Care Med. 2024 Feb 1;25(2):106-117.
Determinants of fluid use and the association between volume of fluid used and effect of balanced solutions on mortality in critically ill patients: a secondary analysis of the BaSICS trial. Zampieri FG, Machado FR, Veiga VC, Azevedo LCP, Bagshaw SM, Damiani LP, Cavalcanti AB. Intensive Care Med. 2024 Jan;50(1):79-89.
Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network; Shapiro NI, Douglas IS, Brower RG, Brown SM, Exline MC, Ginde AA, Gong MN, Grissom CK, Hayden D, Hough CL, Huang W, Iwashyna TJ, Jones AE, Khan A, Lai P, Liu KD, Miller CD, Oldmixon K, Park PK, Rice TW, Ringwood N, Semler MW, Steingrub JS, Talmor D, Thompson BT, Yealy DM, Self WH. N Engl J Med. 2023 Feb 9;388(6):499-510.
