Ringer’s Lactate vs Normal Saline for Children with Acute Diarrhea and Severe Dehydration: A Double Blind Randomized Controlled Trial.
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Date
2012-12
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Abstract
Objective: WHO recommends Ringer’s lactate (RL) and Normal
Saline (NS) for rapid intravenous rehydration in childhood
diarrhea and severe dehydration. We compared these two fluids
for improvement in pH over baseline during rapid intravenous
rehydration in children with acute diarrhea.
Design: Double-blind randomized controlled trial
Setting: Pediatric emergency facilities at a tertiary-care referral
hospital.
Intervention: Children with acute diarrhea and severe
dehydration received either RL (RL-group) or NS (NS-group), 100
mL/kg over three or six hours. Children were reassessed after
three or six hours. Rapid rehydration was repeated if severe
dehydration persisted. Blood gas was done at baseline and
repeated after signs of severe dehydration disappeared.
Outcome Measures: Primary outcome was change in pH from
baseline. Secondary outcomes included changes in serum
R E S E A R C H P A P E R
INDIAN PEDIATRICS 963 VOLUME 49__DECEMBER 16, 2012
electrolytes, bicarbonate levels, and base-deficit from baseline;
mortality, duration of hospital stay, and fluids requirement.
Results: Twenty two children, 11 each were randomized to the
two study groups. At primary end point (disappearance of signs of
severe dehydration), the improvement in pH from baseline was
not significant in RL-group [from 7.17 (0.11) to 7.28 (0.09)] as
compared to NS-group [7.09 (0.11) to 7.21 (0.09)], P=0.17 (after
adjusting for baseline serum Na/ Cl). Among this limited sample
size, children in RL group required less fluids [median 310 vs 530
mL/kg, P=0.01] and had shorter median hospital stay [38 vs 51
hours, P=0.03].
Conclusions: There was no difference in improvement in pH over
baseline between RL and NS among children with acute diarrhea
and severe dehydration.
Description
Keywords
Diarrhea, Intravenous fluid, pH, Severe dehydration
Citation
Mahajan Vidushi, Saini Sajan Shiv, Sharma Amit, Kaur Jasbinder. Ringer’s Lactate vs Normal Saline for Children with Acute Diarrhea and Severe Dehydration: A Double Blind Randomized Controlled Trial. Indian Pediatrics. 2012 December; 49(12): 963-968.