26/05/2026
Ottawa, Ontario — Tuesday May 26, 2026
When children arrive in emergency departments with septic shock, rapid fluid resuscitation is a critical part of care. But can the type of fluids used make a difference?
Balanced fluids—designed to more closely resemble electrolyte composition blood plasma—have been thought to possibly lead to better outcomes than standard saline.
To answer this question more definitively, a new international clinical study published in the New England Journal of Medicine followed more than 9,000 children treated for suspected septic shock across 47 emergency departments in five countries. Waleed Alqurashi alongside Fuad Alnaji led participation at CHEO, the site with the second-largest enrollment in Canada.
“We’re proud to have been the second-largest recruiting site in Canada for this study. It shows the capacity and commitment of our clinical and research teams to conduct research that improves the care children receive at CHEO and around the world.” – Dr. Waleed Alqurashi
Study participants received either a balanced fluid, or 0.9% saline solution as part of their resuscitation fluids.
The primary outcomes measured — including death, kidney replacement therapy, or ongoing kidney dysfunction — occurred in 3.4% of children who received balanced fluid and 3.0% of those who received saline, a difference that was not statistically significant. In other words, neither fluid offered a clear advantage in preventing serious kidney injury or death.
This was the largest study ever done to compare the fluids used to treat children with septic shock in emergency departments. Its findings give clear guidance to help clinical teams make informed decisions, helping ensure children and families receive effective, evidence-based care.