Comparison of 0.9% Saline vs ringers lactate as resuscitation and maintenance fluid in critically ill children: A single blinded randomized comparative trial

Background: Normal saline is still the most used resuscitation and maintenance fluid in children. This study aimed to compare ringer lactate (RL) and 0.9% saline (NS) as resuscitation and maintenance fluid in critically ill children in terms of acid-base homeostasis and dyselectrolytemia. Subjects and Methods: This single-blind randomized comparative study, was conducted in a multidisciplinary pediatric critical care unit at a tertiary care children’s hospital (June 2022–May 2023). All patients from 1 month up to 12 years with hypo perfusion requiring fluid resuscitation at admission were randomized into two groups and fluid was administered till the endpoints of shock resuscitation were achieved. All the samples were collected at the time of admission (T0), at 12 h (T12) and 24 h (T24). Results: This study included 80 patients, out of which five patients were included as the intention to treat. The volume of fluid (NS vs. RL) required for resuscitation (mean ± standard deviation [SD]) was 200.75 ± 165.81 versus 294.25 ± 396.58 and maintenance (mean ± SD) 975.65 ± 577.29 versus 850.28 ± 580.81 statistically not significant ( P > 0.05). We observed no significant difference in the pH and electrolyte status at 24 h of fluid therapy ( P > 0.05). There was no significant association between the incidence of acute kidney injury and metabolic acidosis with NS infusion. Conclusions: Fluid therapy with RL or NS during the first 24 h had no significant difference in the acid-base status and electrolyte imbalance in critically ill children when used as a resuscitation and maintenance fluid.