Hypertonic Versus Normal Saline as Initial Fluid Bolus in Pediatric Septic Shock.
Summary of "Hypertonic Versus Normal Saline as Initial Fluid Bolus in Pediatric Septic Shock."
OBJECTIVE:
To compare the efficacy of 3% saline and 0.9% saline infusion as initial resuscitative fluid therapy in children with septic shock.
METHODS:
Sixty children between 2 to 12 years of age with septic shock were randomized to receive normal saline or 3% saline as initial resuscitative fluid. Fluid resuscitation was done with 0.9% saline in boluses of 20 ml/kg, each bolus over a duration of 15 min with a maximum of 2 boluses. Fluid resuscitation with 3% saline was given as a single bolus of 15 ml/kg over 30 min. After initial fluid bolus completion, if hemodynamic stability was not achieved then further fluid boluses of 0.9% saline were given in volumes of 5-10 ml/kg guided by CVP.
RESULTS:
There were 30 patients in both the groups. Both the groups were identical with respect to age, gender, primary diagnosis, laboratory parameters, initial hemodynamic parameters and PRISM score at time of admission. The amount of total fluid bolus required for resuscitation was approximately half in the group who received 3% saline as compared to the group who received 0.9% saline. The use of vasopressor drugs, shock reversal time, ICU stay and mortality rate were similar in both the groups. No adverse effects related to fluid therapy were observed in any of the groups.
CONCLUSIONS:
Both normal saline and hypertonic saline were equally effective as resuscitation fluid with respect to restoration of hemodynamic stability, average duration of ICU stay and mortality. Hypertonic saline appears to be a promising fluid for resuscitation of septic shock.
Affiliation
Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi-1, India, abhishekmamc2006@yahoo.co.in.
Journal Details
This article was published in the following journal.
Name: Indian journal of pediatrics
ISSN: 0973-7693
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21290201
- DOI: http://dx.doi.org/10.1007/s12098-011-0366-4
Medical and Biotech [MESH] Definitions
Saline Solution, Hypertonic
Hypertonic sodium chloride solution. A solution having an osmotic pressure greater than that of physiologic salt solution (0.9 g NaCl in 100 ml purified water).
Hypertonic Solutions
Solutions that have a greater osmotic pressure than a reference solution such as blood, plasma, or interstitial fluid.
Infusions, Intraosseous
The administration of medication or fluid through a needle directly into the bone marrow. The technique is especially useful in the management of pediatric emergencies when intravenous access to the systemic circulation is difficult.
Haloarcula
A genus of HALOBACTERIACEAE distinguished from other genera in the family by the presence of specific derivatives of TGD-2 polar lipids. Haloarcula are found in neutral saline environments such as salt lakes, marine salterns, and saline soils.
Halomonadaceae
A family of gram-negative, moderately halophilic bacteria in the order Oceanospirillales. Members of the family have been isolated from temperate and Antarctic saline lakes, solar salt facilities, saline soils, and marine environments.
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