UPMC Children’s Trial Aims to Identify which IV Fluid is Best for Pediatric Sepsis

By: Andrea Kunicky

When a child arrives at an emergency department and the clinician suspects sepsis, one of the most important first treatments is to give fluid intravenously.

But there are several options for what IV fluid to give, and doctors don’t know which is best.

UPMC Children’s Hospital of Pittsburgh is participating in the Pragmatic Pediatric Trial of Balanced Versus Normal Saline Fluid in Sepsis (PRoMPT BOLUS) to figure that out.

Sepsis is a rare, but critical medical condition that escalates rapidly. National guidelines recommend treatment begin within 20 minutes of arrival to the emergency department. Over 2,500 children die of sepsis in the U.S. each year, compared to approximately 200 from influenza.

“An important aspect of management of sepsis is initial IV fluid resuscitation. Inadequate fluid resuscitation has been shown to worsen patient outcomes,” said Dr. Robert Hickey, director of research in the Division of Pediatric Emergency Medicine at UPMC Children’s. “We are delighted to participate in this important trial that has the potential to impact the nearly 100,000 children who present to emergency departments in the United States with severe sepsis each year.”

The purpose of this multi-center research study, involving over 20 children’s hospitals, is to determine if one type of IV fluid is better than another at protecting kidney function in treatment of pediatric patients with sepsis, a severe inflammatory response to an infection that can impair the normal function of certain organ systems.

Doctors will enroll patients who present to the emergency department with suspected septic shock and treat them with one of the commonly used fluids, along with the best locally available medical care, unless patients opt out or decide to withdraw from study completion.

All IV solutions used in this study are approved by the U.S. Food and Drug Administration and are recommended as part of standard care for sepsis, restoring fluid balance to improve blood pressure and lower heart rate.

Learn more on about PRoMPT BOLUS, how patients will be enrolled in the emergency department and how families may opt out.