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Indian Journal of Pediatrics

19-03-2024 | Acute Kidney Injury | Original Article

5% Dextrose in Ringer’s Lactate versus 5% Dextrose Normal Saline as Maintenance Intravenous Fluid Therapy in Children — A Randomised Controlled Trial

Authors: Hemanth Kaviti, Joseph John, Krishna Mohan Gulla, Suchanda Sahu

Published in: Indian Journal of Pediatrics

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Abstract

Objectives

To estimate the difference in serum chloride levels between children receiving 5% Dextrose in Ringer’s Lactate (RLD5) vs. 5% Dextrose Normal Saline (DNS) and to estimate the incidence of dyselectrolytemia, hyperchloremic metabolic acidosis (HCMA), acute kidney injury (AKI) and all-cause mortality in both groups.

Methods

A randomised controlled trial was conducted in non-critically ill children aged 6 mo to 14 y, admitted between August 2021 and July 2022, requiring intravenous fluids. A sample size of 140 was estimated and randomised, with controls receiving 5% DNS and the intervention group receiving RLD5. Kidney function tests and blood gas analysis were done at admission, 24 h and 48 h after starting the maintenance IV fluid, and outcomes were analysed at 24 h and 48 h. Data was collected using a pre-designed data collection form that included demographic and clinical profile details, and outcomes were analysed using SPSS Version 20 software.

Results

Seventy-one children per group were enrolled. The mean chloride difference between the two groups at 24 and 48 h were 1.67 (p-value 0.03) and 2.78 (p-value 0.01), respectively. The incidence of AKI at 24 h and 48 h was 1.4% and 2.8% in the RLD5 group and 0% and 1.4% in the DNS group, respectively. At 24 h and 48 h, 2.8% and 2.8% of children had HCMA in the RLD5 group, and 14% and 4.2% had HCMA in the DNS group, respectively. There was no mortality in either group.

Conclusions

Though clinically insignificant, there was a statistically significant difference in the serum chloride levels between the groups.
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Metadata
Title
5% Dextrose in Ringer’s Lactate versus 5% Dextrose Normal Saline as Maintenance Intravenous Fluid Therapy in Children — A Randomised Controlled Trial
Authors
Hemanth Kaviti
Joseph John
Krishna Mohan Gulla
Suchanda Sahu
Publication date
19-03-2024
Publisher
Springer India
Published in
Indian Journal of Pediatrics
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-024-05077-2