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

Balanced crystalloid fluid does not significantly reduce adverse kidney events compared to 0.9% saline in children with septic shock, with event rates of 3.4% versus 3.0%.

• Why it matters: Determining the optimal fluid for pediatric septic shock is critical to improve outcomes and minimize kidney-related complications, yet evidence remains inconclusive.
• What they did: A large, pragmatic clinical trial involving 8,991 children across five countries compared balanced fluid and 0.9% saline, focusing on major adverse kidney events within 30 days.
• The result: No significant difference was found in kidney-related adverse events or hospital-free days between groups, although hyperchloremia was more common with saline, informing fluid choice in pediatric septic shock management.