Two common IV fluids perform equally well for treating septic shock in kids

by Ann & Robert H. Lurie Children's Hospital of Chicago

edited by Gaby Clark, reviewed by Robert Egan

Gaby Clark

Scientific Editor

Meet our editorial team
Behind our editorial process

Robert Egan

Associate Editor

Meet our editorial team
Behind our editorial process Editors' notes

This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility:

fact-checked

peer-reviewed publication

trusted source

proofread

The GIST Add as preferred source

A randomized clinical trial conducted across five countries in 47 pediatric emergency departments, including Ann & Robert H. Lurie Children's Hospital in Chicago, established that both commonly used IV fluids for treating septic shock—balanced crystalloid fluid and 0.9% saline—are equally safe and effective. Results were published in the New England Journal of Medicine.

Septic shock is a life-threatening medical emergency in which the body's extreme response to infection causes organ failure. Treatment with IV fluids, either balanced crystalloid fluid (which mimics blood composition) or 0.9% saline, is used for resuscitation. Previous smaller studies have shown mixed results as to whether balanced fluid is more beneficial, especially for the kidneys, than saline.

"Our study provides a definitive answer that there is no additional benefit or harm from using one type of IV fluid over another for septic shock resuscitation in children," said study co-author Elizabeth Alpern, MD, MSCE, Division Head of Emergency Medicine at Lurie Children's and Professor of Pediatrics at Northwestern University Feinberg School of Medicine.

"We found no difference in outcomes, such as major adverse kidney event or persistent kidney dysfunction at 30 days. This is great news, since centers around the world can now confidently use whichever of these IV fluids is readily available."

Over 9,000 children, aged 2 months to less than 18 years, with suspected septic shock were enrolled in the study.

Since obtaining standard informed consent prior to participation is not always feasible in an emergency, researchers engaged the community for input while still developing the study. Focus groups were held with parents of children at highest risk for sepsis, such as patients with cancer, immune deficiencies and other complex conditions.

At Lurie Children's, the Family Advisory Board and Kids Advisory Board were involved. Families with children in the emergency department and pediatric intensive care unit were surveyed, and feedback from the general community was solicited online and via posters at the hospital. Families were able to opt out of the study in advance.

"It was very important to us to make sure that parents and patients understood what we were trying to accomplish, and that we heard and addressed any possible concerns prior to launching this study," said Dr. Alpern. "We greatly appreciate their collaboration and are pleased to share our results. Now we can move on from the debate about what kind of fluid is best and focus on new ways to improve care for kids with septic shock."

Publication details

Balanced Fluid or 0.9% Saline in Children Treated for Septic Shock, New England Journal of Medicine (2026). DOI: 10.1056/NEJMoa260196. www.nejm.org/doi/full/10.1056/NEJMoa2601969

Journal information: New England Journal of Medicine

Key medical concepts

Shock, SepticBalanced Crystalloid Solution

Clinical categories

PediatricsEmergency medicineChildren's healthCritical care medicine Provided by Ann & Robert H. Lurie Children's Hospital of Chicago Who's behind this story?

Gaby Clark

MA in English, copy editor since 2021 with experience in higher education and health content. Dedicated to trustworthy science news. Full profile →

Robert Egan

Bachelor's in mathematical biology, Master's in creative writing. Well-traveled with unique perspectives on science and language. Full profile →

Citation: Two common IV fluids perform equally well for treating septic shock in kids (2026, June 5) retrieved 5 June 2026 from https://medicalxpress.com/news/2026-06-common-iv-fluids-equally-septic.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.