TDNet Discover

Background: Pediatric dehydration is a common yet potentially serious condition contributing to significant morbidity and hospitalizations worldwide. Clinical guidelines typically recommend 0.9% normal saline for fluid resuscitation, but recent evidence suggests that balanced solutions may offer improved metabolic outcomes. However, there is limited consensus on whether these solutions provide clinically significant benefits over traditional fluids. Purpose: This study aimed to evaluate whether balanced solutions such as Ringer’s lactate or Plasma-Lyte offer superior outcomes compared to 0.9% normal saline in the management of mild to moderate dehydration in pediatric patients. Primary outcomes included hydration status, hospital length of stay, biochemical measures, and incidence of adverse events. Methods: An evidence-based clinical review (EBCR) was conducted using systematic searches of PubMed, Google Scholar, and Cochrane Review. Inclusion criteria targeted pediatric populations with dehydration. A total of 3 high-quality studies including 1 meta-analysis, 1 systematic review, and 1 randomized controlled trial were selected. These studies were then analyzed using a standardized extraction tool and reviewed for outcomes related to fluid type. Results: Balanced solutions were associated with modest improvements in acid-base balance, such as higher pH and bicarbonate levels, and lower post-resuscitation chloride. Some studies suggested a small reduction in hospital stay and lower risk of hypokalemia with balanced solutions. However, there were no significant differences in fluid volume required, clinical resolution, or major adverse kidney events (MAKE) when compared to normal saline. Conclusion: While balanced solutions may offer metabolic advantages, these benefits did not consistently translate into improved clinical outcomes. The findings support the safety and efficacy of both fluid types, emphasizing the importance of individualized fluid selection based iv on clinical context. Further multicenter trials are needed to clarify the long-term implications of fluid choice in pediatric rehydration.