Balanced Fluid or 0.9% Saline in Children Treated for Septic Shock

F Fran Balamuth (Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia) S Scott L. Weiss (Division of Critical Care, Department of Pediatrics, Nemours Children’s Hospital, Wilmington, DE) E Elliot Long (Emergency Department, Royal Children’s Hospital, Parkville, VIC, Australia) G Graham C. Thompson (Departments of Pediatrics and Emergency Medicine, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada) A Amanda S. Artis (Department of Biomedical and Health Informatics, Data Science and Biostatistics Unit, Children’s Hospital of Philadelphia, Philadelphia) A Atzael B. Campos (Department of Biomedical and Health Informatics, Clinical Reporting Unit, Children’s Hospital of Philadelphia, Philadelphia) M Meredith L. Borland (Department of Emergency Medicine, Perth Children’s Hospital, Nedlands, WA, Australia) S Stuart R. Dalziel (Departments of Surgery and Pediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand) A Adriana Yock-Corrales (Department of Emergency Medicine, Hospital Nacional de Niños Dr. Carlos Sáenz Herrera, Caja Costarricense del Seguro Social, San José, Costa Rica) R Ruchi Singh (Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia) A Amanda Williams B Beata Mickiewicz (Departments of Pediatrics and Emergency Medicine, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada) C Christopher P. Hickey (Children’s Hospital of Philadelphia Pediatric Sepsis Program, Philadelphia) J Julie C. Fitzgerald (Children’s Hospital of Philadelphia Pediatric Sepsis Program, Philadelphia) B Benjamin L. Laskin (Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia) R Robert W. Hickey (Division of Pediatric Emergency Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh) M Michelle Eckerle (Department of Pediatrics, University of Cincinnati College of Medicine and Division of Emergency Medicine, Cincinnati Children’s Hospital, Cincinnati) W Waleed Alqurashi E Elizabeth Alpern (Division of Emergency Medicine, Department of Pediatrics, Ann and Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago) L Lilliam Ambroggio (Section of Pediatric Emergency Medicine, Department of Pediatrics, Children’s Hospital Colorado and the Department of Pediatrics, University of Colorado Anschutz School of Medicine, Aurora) M Mohamed Badawy (Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Children’s Medical Center, Dallas) S Shannon Baumer-Mouradian (Department of Pediatrics, Medical College of Wisconsin and Children’s Wisconsin, Milwaukee) S Simon Berthelot L Lindsay D. Clukies (Division of Emergency Medicine, Department of Pediatrics, St. Louis Children’s Hospital, Washington University School of Medicine, St. Louis) S Simon Craig (Paediatric Emergency Department, Monash Medical Centre, Melbourne, VIC, Australia) S Sarah J. Curtis (Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Alberta Stollery Children’s Hospital, Edmonton, Canada) A Adrienne L. Davis (Division of Emergency Medicine, Department of Pediatrics, Hospital for Sick Children and the Department of Paediatrics, University of Toronto, Toronto) S Susan Duffy (Hasbro Children’s Hospital, Brown University Health, Providence, RI) M Matthew A. Eisenberg (Division of Emergency Medicine, Department of Pediatrics, Boston Children’s Hospital, Boston) J Jason G. Emsley (IWK Health Centre and Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, Dalhousie University, Halifax NS, Canada) A Ara Festekjian (Division of Emergency and Transport Medicine, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles) S Shane George (Department of Emergency Medicine and Children’s Critical Care, Gold Coast University Hospital, Southport, QLD, Australia) R Rebecca Green (Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia) K Karen E. Gripp (Section of Pediatric Emergency Medicine, Department of Pediatrics and Child Health, Health Sciences Center Winnipeg Children’s Hospital, Winnipeg, MB, Canada) P Priya G. Jain (Division of Emergency Medicine, Department of Pediatrics, Ann and Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago) S Shefali Jani (Department of Emergency Medicine, Children’s Hospital at Westmead, Westmead, NSW, Australia) G Gary I. Joubert (London Health Sciences Centre and Division of Emergency Medicine, Department of Paediatrics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada) P Pavan Judge (British Columbia Children’s Hospital, Department of Pediatrics, Division of Pediatric Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada) A April Kam A Amit Kochar (Department of Emergency Medicine, Women’s and Children’s Hospital, Adelaide, SA, Australia) I Ioannis Koutroulis (Division of Emergency Medicine, Department of Pediatrics, Children’s National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC) M Maria Y. Kwok (Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York–Presbyterian Morgan Stanley Children’s Hospital, New York) R Roni D. Lane (Division of Pediatric Emergency Medicine, Primary Children’s Hospital, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City) A Anna Lithgow (Department of Paediatrics, Royal Darwin Hospital, Tiwi, NT, Australia) J Julia Lloyd (Division of Emergency Medicine, Department of Pediatrics, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus) K Karim Mansour (Division of Pediatric Emergency Medicine, Department of Emergency Medicine, University of California San Francisco Benioff Children’s Hospitals, Oakland) J Julie K. McManemy (Division of Emergency Medicine, Department of Pediatrics, Texas Children’s Hospital and the Department of Pediatrics, Baylor College of Medicine, Houston) C Claudia Morris (Division of Pediatric Emergency Medicine, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta) N Natalie Phillips A Arjun Rao (Department of Emergency Medicine, Sydney Children’s Hospital, Randwick, NSW, Australia) A Alexander Rogers (Departments of Emergency Medicine and Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor) A Anupam Sehgal (Kingston Health Sciences Centre and Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada) Y Yasaman Shayan (Centre Hospitalier Universitaire Sainte Justine et Département de Pédiatrie, Université de Montréal, Montreal) J Jonathan Silverman (Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Division of Critical Care, Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond) E Eunicia Tan (Middlemore Hospital, Auckland, New Zealand) N Neil G. Uspal (University of Washington, Pediatric Emergency Medicine, Seattle Children’s Hospital, Seattle) C Cheryl Vance (University of California at Davis Children’s Hospital and School of Medicine, Sacramento) E Emma Whyte (Emergency Department, Townsville University Hospital, Douglas, QLD, Australia) J Jing Huang S Stephen B. Freedman F Franz E. Babl (Emergency Department, Royal Children’s Hospital, Parkville, VIC, Australia) N Nathan Kuppermann (Division of Emergency Medicine, Department of Pediatrics, Children’s National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC)

Article Details

Volume / Issue Vol. 1, Issue 1
Published April 23, 2026
ISSN 0028-4793
Publisher Massachusetts Medical Society

Journal Info

New England Journal of Medicine

Massachusetts Medical Society

ISSN: 0028-4793 Social Sciences

Authors (62)

F

Fran Balamuth

Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia

S

Scott L. Weiss

Division of Critical Care, Department of Pediatrics, Nemours Children’s Hospital, Wilmington, DE

E

Elliot Long

Emergency Department, Royal Children’s Hospital, Parkville, VIC, Australia

G

Graham C. Thompson

Departments of Pediatrics and Emergency Medicine, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada

A

Amanda S. Artis

Department of Biomedical and Health Informatics, Data Science and Biostatistics Unit, Children’s Hospital of Philadelphia, Philadelphia

A

Atzael B. Campos

Department of Biomedical and Health Informatics, Clinical Reporting Unit, Children’s Hospital of Philadelphia, Philadelphia

M

Meredith L. Borland

Department of Emergency Medicine, Perth Children’s Hospital, Nedlands, WA, Australia

S

Stuart R. Dalziel

Departments of Surgery and Pediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand

A

Adriana Yock-Corrales

Department of Emergency Medicine, Hospital Nacional de Niños Dr. Carlos Sáenz Herrera, Caja Costarricense del Seguro Social, San José, Costa Rica

R

Ruchi Singh

Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia

A

Amanda Williams

B

Beata Mickiewicz

Departments of Pediatrics and Emergency Medicine, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada

C

Christopher P. Hickey

Children’s Hospital of Philadelphia Pediatric Sepsis Program, Philadelphia

J

Julie C. Fitzgerald

Children’s Hospital of Philadelphia Pediatric Sepsis Program, Philadelphia

B

Benjamin L. Laskin

Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia

R

Robert W. Hickey

Division of Pediatric Emergency Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh

M

Michelle Eckerle

Department of Pediatrics, University of Cincinnati College of Medicine and Division of Emergency Medicine, Cincinnati Children’s Hospital, Cincinnati

W

Waleed Alqurashi

E

Elizabeth Alpern

Division of Emergency Medicine, Department of Pediatrics, Ann and Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago

L

Lilliam Ambroggio

Section of Pediatric Emergency Medicine, Department of Pediatrics, Children’s Hospital Colorado and the Department of Pediatrics, University of Colorado Anschutz School of Medicine, Aurora

M

Mohamed Badawy

Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Children’s Medical Center, Dallas

S

Shannon Baumer-Mouradian

Department of Pediatrics, Medical College of Wisconsin and Children’s Wisconsin, Milwaukee

S

Simon Berthelot

L

Lindsay D. Clukies

Division of Emergency Medicine, Department of Pediatrics, St. Louis Children’s Hospital, Washington University School of Medicine, St. Louis

S

Simon Craig

Paediatric Emergency Department, Monash Medical Centre, Melbourne, VIC, Australia

S

Sarah J. Curtis

Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Alberta Stollery Children’s Hospital, Edmonton, Canada

A

Adrienne L. Davis

Division of Emergency Medicine, Department of Pediatrics, Hospital for Sick Children and the Department of Paediatrics, University of Toronto, Toronto

S

Susan Duffy

Hasbro Children’s Hospital, Brown University Health, Providence, RI

M

Matthew A. Eisenberg

Division of Emergency Medicine, Department of Pediatrics, Boston Children’s Hospital, Boston

J

Jason G. Emsley

IWK Health Centre and Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, Dalhousie University, Halifax NS, Canada

A

Ara Festekjian

Division of Emergency and Transport Medicine, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles

S

Shane George

Department of Emergency Medicine and Children’s Critical Care, Gold Coast University Hospital, Southport, QLD, Australia

R

Rebecca Green

Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia

K

Karen E. Gripp

Section of Pediatric Emergency Medicine, Department of Pediatrics and Child Health, Health Sciences Center Winnipeg Children’s Hospital, Winnipeg, MB, Canada

P

Priya G. Jain

Division of Emergency Medicine, Department of Pediatrics, Ann and Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago

S

Shefali Jani

Department of Emergency Medicine, Children’s Hospital at Westmead, Westmead, NSW, Australia

G

Gary I. Joubert

London Health Sciences Centre and Division of Emergency Medicine, Department of Paediatrics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada

P

Pavan Judge

British Columbia Children’s Hospital, Department of Pediatrics, Division of Pediatric Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada

A

April Kam

A

Amit Kochar

Department of Emergency Medicine, Women’s and Children’s Hospital, Adelaide, SA, Australia

I

Ioannis Koutroulis

Division of Emergency Medicine, Department of Pediatrics, Children’s National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC

M

Maria Y. Kwok

Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York–Presbyterian Morgan Stanley Children’s Hospital, New York

R

Roni D. Lane

Division of Pediatric Emergency Medicine, Primary Children’s Hospital, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City

A

Anna Lithgow

Department of Paediatrics, Royal Darwin Hospital, Tiwi, NT, Australia

J

Julia Lloyd

Division of Emergency Medicine, Department of Pediatrics, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus

K

Karim Mansour

Division of Pediatric Emergency Medicine, Department of Emergency Medicine, University of California San Francisco Benioff Children’s Hospitals, Oakland

J

Julie K. McManemy

Division of Emergency Medicine, Department of Pediatrics, Texas Children’s Hospital and the Department of Pediatrics, Baylor College of Medicine, Houston

C

Claudia Morris

Division of Pediatric Emergency Medicine, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta

N

Natalie Phillips

A

Arjun Rao

Department of Emergency Medicine, Sydney Children’s Hospital, Randwick, NSW, Australia

A

Alexander Rogers

Departments of Emergency Medicine and Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor

A

Anupam Sehgal

Kingston Health Sciences Centre and Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada

Y

Yasaman Shayan

Centre Hospitalier Universitaire Sainte Justine et Département de Pédiatrie, Université de Montréal, Montreal

J

Jonathan Silverman

Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Division of Critical Care, Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond

E

Eunicia Tan

Middlemore Hospital, Auckland, New Zealand

N

Neil G. Uspal

University of Washington, Pediatric Emergency Medicine, Seattle Children’s Hospital, Seattle

C

Cheryl Vance

University of California at Davis Children’s Hospital and School of Medicine, Sacramento

E

Emma Whyte

Emergency Department, Townsville University Hospital, Douglas, QLD, Australia

J

Jing Huang

S

Stephen B. Freedman

F

Franz E. Babl

Emergency Department, Royal Children’s Hospital, Parkville, VIC, Australia

N

Nathan Kuppermann

Division of Emergency Medicine, Department of Pediatrics, Children’s National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC