ORIGINAL ARTICLE   Open access

Italian Journal of Emergency Medicine 2020 April;9(1):29-34

DOI: 10.23736/S2532-1285.20.00019-1

Copyright © 2020 THE AUTHORS

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language: English

Ringer lactate versus saline solution for resuscitation of sepsis and septic shock

Antonio PAGANO ¹ ✉, Giovanni PORTA ¹, Giorgio BOSSO ¹, Valerio ROSATO ², Enrico ALLEGORICO ¹, Claudia SERRA ¹, Alfonso SFORZA ³, Fiorella PALADINO ⁴, Fabio G. NUMIS ¹

¹ Santa Maria delle Grazie Hospital, Naples, Italy; ² University of Salerno, Salerno, Italy; ³ AORN dei Colli, Naples, Italy; ⁴ AORN Cardarelli, Naples, Italy

BACKGROUND: Sepsis and septic shock are the main causes of morbidity and mortality in critically ill patients. Fluid resuscitation is a cornerstone of therapy. The aim of this study was to compare saline solution to Ringer lactate in resuscitation of patients with sepsis and septic shock.
METHODS: We randomly assigned patients who had been admitted to the emergency department for sepsis or septic shock to receive either ringer lactate or normal saline for intravascular-fluid resuscitation. The primary outcome measure was in-hospital death from any cause. Second outcomes were requirement of mechanical ventilation and worsening of renal function.
RESULTS: Among the 84 patients, 35 receive Ringer Lactate and 49 saline solution. The two groups had similar baseline characteristics. There were 8 deaths in the Ringer Lactate group, as compared with 28 deaths in the saline group (27.6% versus 63%; P=0.003). There were no significant differences between the groups in need of mechanical ventilation (4.5±6.1 and 4.3±5.7, respectively; P=0.74), or worsening of renal function.
CONCLUSIONS: Patients with sepsis or septic shock resuscitated using lactated Ringer had a lower mortality than those resuscitated with 0.9% NaCl solution.

KEY WORDS: Sepsis; Shock; Ringer’s lactate