Balanced Fluid or 0.9% Saline in Children Treated for Septic Shock.

Balanced crystalloid fluid did not improve outcomes over 0.9% saline in children with septic shock. In the PRoMPT BOLUS trial, conducted at 47 emergency departments in five countries, a major adverse kidney event occurred in 3.4% of the balanced-fluid group (137 of 4235 patients) versus 3.0% of the saline group (124 of 4247 patients) (risk ratio, 1.10; 95% CI, 0.88 to 1.40). Hyperchloremia was more frequent with saline, 49.0% versus 31.4%, without affecting the primary outcome.