Outcomes After Initial Rehydration with Isotonic Saline or Ringer's Lactate in Pediatric Acute Gastroenteritis (1-59 Months): A Single-center Retrospective Cross-sectional Study
Haseki Tip Bulteni, cilt.63, sa.5, ss.258-266, 2025 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 63 Sayı: 5
- Basım Tarihi: 2025
- Doi Numarası: 10.4274/haseki.galenos.2025.46855
- Dergi Adı: Haseki Tip Bulteni
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.258-266
- Anahtar Kelimeler: Child, dehydration, gastroenteritis, fluid therapy, sodium chloride, Ringer's lactate
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: The optimal choice of initial intravenous crystalloid solution in pediatric acute gastroenteritis (AGE) remains a matter of clinical debate due to differing effects on acid–base status and overall recovery. In this context, we aimed to compare clinical recovery and laboratory changes in children with AGE treated with isotonic saline (IS) versus Ringer’s lactate (RL) as initial replacement therapy. Methods: This single-center retrospective cross-sectional study included patients aged 1-59 months who presented with dehydration due to AGE and received initial intravenous rehydration with either IS or RL between January 2022 and February 2023. The primary outcome was the change in a standardized dehydration score from presentation to post-treatment. Secondary outcomes were pre- and post-treatment blood gas and electrolyte values. The comparisons used appropriate statistical tests. Results: Both groups showed significant clinical improvement after fluid therapy. Dehydration scores decreased, and lactate levels fell significantly from baseline in each group (p<0.001 for both). Post-treatment electrolyte and acid-base parameters improved in both arms, with no serious adverse events. Between-group differences favored RL for overall clinical recovery and metabolic profile, although most laboratory changes were similar across groups. Conclusion: In pediatric AGE, initial isotonic crystalloid replacement rapidly improves clinical and laboratory parameters. Due to its balanced composition and demonstrated benefits in overall recovery, RL may be favored as the primary replacement solution, whereas IS continues to serve as a viable alternative. Prospective randomized trials are warranted to confirm these findings.