COMPARISON OF OUTCOME BETWEEN RINGER’S LACTATE AND NORMAL SALINE FLUID REPLACEMENT IN PEDIATRIC PATIENTS WITH ACUTE WATERY DIARRHOEA

Abstract

Objective: To compare ringer’s lactate and normal saline fluid replacement in pediatric patients with acute watery diarrhoea in terms of mean serum bicarbonate, potassium and pH.

Study Design: Quasi experimental study.

Place and Duration of Study: This study was conducted at the department of Pediatrics, Pak Emirates Military Hospital, Rawalpindi from Feb 2015 to Jul 2015.

Methodology: This study involved 206 children of both genders aged between 1-5 years with watery diarrhoea and severe dehydration. These patients were randomly divided into two treatment groups each comprising of 103 patients. Patients in group-A received ringer’s lactate while group-B patients were given normal saline as replacement fluids.

Results: The mean age of the patients was 3.34 ± 1.19 years and there were 112 (54.4%) male and 94 (45.6%) female patients. Both the groups were comparable in terms of mean age (p=0.861) and gender distribution (p=0.576). After 6 hours of initiating fluid therapy, mean serum bicarbonate (13.61 ± 2.41 vs. 9.72 ± 2.07 meq/l; p<0.001) and mean blood pH (7.46 ± 0.02 vs. 7.38 ± 0.03; p<0.001) were significantly higher in children treated with ringer’s lactate as compared to normal saline. While there was no significant difference between the two groups (4.35 ± 0.61 vs. 4.27 ± 0.58 meq/l; p=0.319) in terms of mean serum potassium level.

Conclusion: Fluid replacement with ringer’s lactate was superior to normal saline in terms of significantly higher mean serum bicarbonate and mean blood pH after 6 hours of initiating therapy while it was equally safe and only caused insignificant increase in mean serum potassium level.