Evaluation of the Therapeutic Effects of Ringer’s Lactate Versus Normal Saline in Resuscitation of Severely Dehydrated Children with Acute Gastroenteritis: A Randomized Clinical Trial
Abstract
Background: Fluid resuscitation plays a crucial role in the treatment of severely dehydrated children. There is evidence that chloride-rich fluids such as normal saline (NS) may cause hyperchloremic normal anion gap metabolic acidosis, hypernatremia, and hyperkalemia. There is also concern about the occurrence of acute kidney injury caused by renal vasoconstriction. Objectives: Given the lack of sufficient data in the pediatric field, this study was designed to compare the therapeutic effects of Ringer’s Lactate (RL) versus NS in two groups of severely dehydrated children. Methods: In this randomized, parallel-group clinical trial, 104 children with severe dehydration were randomly assigned to receive either NS or RL using block randomization with allocation concealment. Vital signs, mental status, number of fluid boluses, length of hospital stay, recovery from severe dehydration, capillary refill time, skin turgor, serum electrolytes, arterial blood gas (ABG) parameters, and urine output were recorded over six hours of treatment. Data were analyzed using Independent Sample t-tests in SPSS version 26, with a significance level of P < 0.05. Results: RL showed a significant difference regarding improvement of pH, bicarbonate, base excess, and anion gap compared to NS after 6 hours of treatment (P < 0.001, P < 0.007, P < 0.010, and P < 0.014, respectively). Establishment of urine output and reduction of pulse rate were greater in recipients of RL (P = 0.047, P < 0.001). NS was…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 104 participants or records.
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