A major clinical trial published in the New England Journal of Medicine has tested whether balanced fluid or standard saline works better when treating children in septic shock.
The New England Journal of Medicine has published findings from the PRoMPT BOLUS trial, a study examining which intravenous (IV) fluid — balanced fluid or 0.9% saline (sometimes called normal saline) — produces better outcomes when doctors treat children for septic shock (a life-threatening condition in which infection causes the body’s organs to begin failing). An accompanying editorial, titled Fluid Resuscitation in Patients with Sepsis — For Whom the Balance Tolls, also appears in the same issue, offering clinical commentary on what the results mean for emergency and paediatric medicine.
The trial sits within the fields of paediatrics and emergency medicine, according to the journal’s own categorisation. Balanced fluids contain a mix of salts designed to more closely resemble the body’s natural chemistry, while 0.9% saline contains only sodium chloride and has been the standard resuscitation fluid in emergency settings for decades. The question of which is safer and more effective in critically ill children has been debated among clinicians for some time.
The research is published by the NEJM, one of the world’s most widely read peer-reviewed medical journals. The NEJM’s post on X indicates that the trial found no significant difference between the two fluids on key outcomes including death, need for kidney replacement therapy, or persistent kidney dysfunction, though full numerical data appear in the published paper.
For Kent families, sepsis remains a medical emergency. The NHS advises calling 999 immediately if a child shows signs of sepsis — these can include very fast or slow breathing, a rash that does not fade when pressed, or unusual drowsiness. NHS 111 is also available around the clock for urgent health concerns that are not immediately life-threatening.
Key information
- If you suspect sepsis in a child, call 999 immediately — do not wait
- NHS 111 is available 24 hours a day for urgent health advice
- UK Sepsis Trust helpline: 0800 389 6255
Source: @NEJM