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Abstract PD-015: BALANCED SALT SOLUTION VERSUS NORMAL SALINE IN RESUSCITATION OF PEDIATRIC SEPSIS A RANDOMIZED CONTROL TRIAL

Trepatchayakorn, S.1; Samransamruajkit, R.1

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 34
doi: 10.1097/01.pcc.0000537417.21041.ab
Poster Discussion Abstracts
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1Department of Pediatrics- Faculty of Medicine- Chulalongkorn University, Pediatrics, Bangkok, Thailand

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Aims & Objectives:

Rationale Pediatric sepsis is the leading cause of PICU admissions and mortality. Current evidences in resuscitation of adult sepsis pointed to the importance of types of crystalloid and fluid-related complication on resuscitation outcomes, but evidences are lacking in pediatric populations.

Objectives To compare the outcomes of pediatric sepsis resuscitation with different types of crystalloid fluid.

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Methods

We randomly assigned the participants into 3 groups to received NSS, RLS or Sterofundin as bolus fluid therapy. Other standard of cares were continued with primary care physicians’ judgment. Data were analysed using SPSS version 22.

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Results

31 patients were included into the study. Median age 33 mo. (IQR 21 – 60), PELODS-II score at 5 pts. (IQR 1 – 7), PRISM-III score at 5 pts. (IQR 2 – 9 pts.). Median dose of resuscitation fluid was 30 mL/kg (IQR 20 – 40). Baseline demographic data were not significantly different between 3 groups. After resuscitation, acid-base status parameters and fluid-related complications were not significantly different among groups. Subgroup analysis of patients received bolus fluid ≥ 30 mL/kg showed significant better lactate clearance after 24 hrs. in RLS group (p-value 0.046). Mortality, ventilator days, PICU & hospital LOS were not different between groups.

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Conclusions

Resuscitation of pediatric sepsis with RLS when dosing ≥ 30 mL/kg, comparing with NSS, resulted in significant better lactate clearance at 24 hrs. after resuscitation. Balanced salt solution were not associated with significantly different rate of fluid-related complications.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies