0.9% Saline versus Ringer’s lactate as initial fluid in children with diabetic ketoacidosis: a double-blind randomized controlled trial
Authors' conclusion
The time to resolution of DKA was shorter in RL group as compared with the NS group. Regeneration of bicarbonate from lactate ion in the RL forms a strong physiological basis for this outcome as compared with hyperchloremia induced by NS. This makes RL a favorable option in children with DKA.
Study context
- Population
- Children aged 9 months to 12 years with T1D presenting in diabetic ketoacidosis (DKA)
- Participants
- 67 children
- Comparison
- Ringer's lactate vs 0.9% saline as initial fluid
- NSn = 34reference
- Ringer's lactate (RL)n = 33
- Primary endpoint
- Time to resolution of DKA
Methodological detailsdouble-blind, single teaching hospital (pediatric ED and ICU), Conducted December 2020 to December 2021
- Double-blind
- Single teaching hospital (pediatric ED and ICU)
- Conducted December 2020 to December 2021
Primary result
As reported in the abstract
Time to DKA resolution
Mean difference, hours (95% CI)
NSvs RL
3.85(0.3–8)
HR for DKA resolution (event: resolution of DKA), hours (95% CI)
RLvs NSunit as printed
1.39(1.25–1.56)
Secondary outcomes
Rise in serum chloride from baseline · 4 hours
Rise in serum chloride from baseline · 8 hours
| Outcome | NS | RL |
|---|---|---|
| Rise in bicarbonate from baseline · 12 hours | 12.9 ± 3.1 | 14.7 ± 1.6 |
Rise in serum chloride from baseline · 4 hours
- Rise in chloride higher with NS than RL
Rise in serum chloride from baseline · 8 hours
- Rise in chloride higher with NS than RL
Rise in bicarbonate from baseline · 12 hours
- Rise in bicarbonate significantly higher with RL than NS
Original publication
0.9% Saline versus Ringer’s lactate as initial fluid in children with diabetic ketoacidosis: a double-blind randomized controlled trial. BMJ Open Diabetes Res Care. Published 7 April 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →