Plasmalyte versus saline solution for rapid rehydration in gastroenteritis: prospective observational study

Area of Science:

• Pediatric Emergency Medicine
• Pediatric Critical Care
• Clinical Chemistry

Background:

• Current guidelines recommend physiological saline solution (PSS) for rapid intravenous rehydration (RIR) in pediatric dehydration.
• Balanced crystalloid solutions like Plasmalyte (PLA) may offer benefits due to their plasma-like composition.

Purpose of the Study:

• To compare the efficacy and safety of Plasmalyte (PLA) versus physiological saline solution (PSS) for RIR in children with dehydration.
• To evaluate the impact of PLA and PSS on acid-base balance and clinical outcomes.

Main Methods:

• A single-center prospective observational study involving 169 children (3 months to 13 years) with mild to moderate dehydration.
• Patients received either PLA or PSS (40mL/kg over 2h) supplemented with glucose.
• Data collected included clinical and laboratory variables, length of stay, and readmission rates.

Main Results:

• The PLA group showed significantly greater improvement in bicarbonate levels (3.7mmol/L vs 1.4mmol/L) and a lower increase in chloride levels (0.9mmol/L vs 4.1mmol/L) compared to the PSS group.
• No significant differences were observed in clinical dehydration scores, length of stay in the pediatric emergency department, or readmission rates.
• No serious adverse events were reported in either group.

Conclusions:

• Plasmalyte (PLA) is an effective and safe alternative to PSS for RIR in pediatric dehydration.
• PLA administration leads to more favorable changes in bicarbonate and chloride levels compared to PSS.
• While biochemical markers improved, clinical outcomes did not differ between the two solutions.