Balanced crystalloids vs. 0.9% saline in pediatric diabetic ketoacidosis: a systematic review and meta-analysis of randomized controlled trials - Takeaways - MDSpire

Balanced crystalloids vs. 0.9% saline in pediatric diabetic ketoacidosis: a systematic review and meta-analysis of randomized controlled trials

  • By

  • Zeid Alkhairi

  • Charlie Kajo

  • Abdolaziz A. Zadeh

  • Dawood Khaja

  • Mohammad Alqaryuti

  • Nada K. Alsaleh

  • Rataj Alibrahim

  • Fahad Almuhannadi

  • Suod Al Hammad

  • Fatima Alqanea

  • Abdullatif Alfehaid

  • July 9, 2026

  • 0 min

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  • 1

    Fluid resuscitation is essential in managing pediatric diabetic ketoacidosis (DKA), with 0.9% saline being the conventional first-line fluid.

  • 2

    Balanced crystalloids showed a statistically significant decrease in the time to DKA resolution compared to 0.9% saline.

  • 3

    Current evidence is insufficient to determine the effect of fluid choice on new-onset acute kidney injury due to substantial statistical uncertainty.

  • 4

    Balanced crystalloids were associated with a lower incidence of hypokalemia and hyperchloremia compared to 0.9% saline.

  • 5

    The study concludes that further large, multicenter randomized controlled trials are needed to clarify the clinical role of balanced crystalloids in pediatric DKA.

Original Source(s)

Balanced crystalloids vs. 0.9% saline in pediatric diabetic ketoacidosis: a systematic review and meta-analysis of randomized controlled trials

  • by Zeid Alkhairi, Charlie Kajo, Abdolaziz A. Zadeh, Dawood Khaja, Mohammad Alqaryuti, Nada K. Alsaleh, Rataj Alibrahim, Fahad Almuhannadi, Suod Al Hammad, Fatima Alqanea, Abdullatif Alfehaid

  • July 9, 2026

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