---
title: "Balanced Fluid versus 0.9% Saline for Children With Septic Shock: NEJM Randomized Trial"
id: "pubmed-42028918"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42028918"
content_type: "clinical_feed_article"
specialty: "Pediatrics"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42028918/"
doi: "10.1056/NEJMoa2601969"
published_at: "2026-09-03T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Balanced Fluid versus 0.9% Saline for Children With Septic Shock: NEJM Randomized Trial
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42028918
- **Specialty:** [Pediatrics](https://medichelpline.com/clinical-feed/pediatrics.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42028918/)
- **DOI:** [10.1056/NEJMoa2601969](https://doi.org/10.1056%2FNEJMoa2601969)
- **Published At:** 2026-09-03T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The source is a PubMed/NCBI entry for a randomized controlled trial titled “Balanced Fluid or 0.9% Saline in Children Treated for Septic Shock,” published in the New England Journal of Medicine (NEJM), with doi 10.1056/NEJMoa2601969 and Epub date listed as 2026 Apr 24. - The article lists a large multi-author, multinational pediatric research collaboration with lead authors including Fran Balamuth and Scott L. Weiss and many coauthors from pediatric emergency, critical care, and research centers in North America, Australia, and New Zealand. - The trial is identified as a randomized controlled trial comparing **balanced fluid** to **0.9% saline** in children treated for **septic shock**. The NEJM and PubMed records and a free PMC full-text link are provided in the entry. - The JINA source text supplied here includes title, author list, affiliations, publication citation, DOI, and links but does not include the article abstract, trial methods, numerical results, primary or secondary endpoints, statistical findings, or conclusions. - Because the provided PubMed page excerpt does not contain the trial’s methods details, outcome data, or conclusions, those specific clinical results and recommendations are not reported in this source text and therefore are not available for summary here. - The entry indicates that full text is available via NEJM and PubMed Central; readers should consult the full article or the PMC copy for complete trial design, enrollment criteria, outcomes, and authors’ conclusions. - Key searchable identifiers from the source: NEJM, PMID 42028918 (PubMed page), DOI 10.1056/NEJMoa2601969, title referencing **balanced fluid** vs **0.9% saline** in pediatric **septic shock**.
## Clinical Analysis & Structured Key Points
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Epub 2026 Apr 24. # Balanced Fluid or 0.9% Saline in Children Treated for Septic Shock [Fran Balamuth](https://pubmed.ncbi.nlm.nih.gov/?term=Balamuth+F&cauthor_id=42028918)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-1 "Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-2 "Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-3 "Children's Hospital of Philadelphia Pediatric Sepsis Program, Philadelphia."), [Scott L Weiss](https://pubmed.ncbi.nlm.nih.gov/?term=Weiss+SL&cauthor_id=42028918)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-4 "Division of Critical Care, Department of Pediatrics, Nemours Children's Hospital, Wilmington, DE.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-5 "Departments of Pediatrics and Pathology and Genomic Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia."), [Elliot Long](https://pubmed.ncbi.nlm.nih.gov/?term=Long+E&cauthor_id=42028918)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-6 "Emergency Department, Royal Children's Hospital, Parkville, VIC, Australia.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-7 "Departments of Paediatrics and Critical Care, University of Melbourne, Parkville, VIC, Australia.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-8 "Murdoch Children's Research Institute, Parkville, VIC, Australia."), [Graham C Thompson](https://pubmed.ncbi.nlm.nih.gov/?term=Thompson+GC&cauthor_id=42028918)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-9 "Departments of Pediatrics and Emergency Medicine, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada."), [Amanda S Artis](https://pubmed.ncbi.nlm.nih.gov/?term=Artis+AS&cauthor_id=42028918)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-10 "Department of Biomedical and Health Informatics, Data Science and Biostatistics Unit, Children's Hospital of Philadelphia, Philadelphia."), [Atzael B Campos](https://pubmed.ncbi.nlm.nih.gov/?term=Campos+AB&cauthor_id=42028918)[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-11 "Department of Biomedical and Health Informatics, Clinical Reporting Unit, Children's Hospital of Philadelphia, Philadelphia."), [Meredith L Borland](https://pubmed.ncbi.nlm.nih.gov/?term=Borland+ML&cauthor_id=42028918)[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-12 "Department of Emergency Medicine, Perth Children's Hospital, Nedlands, WA, Australia.")[ 13 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-13 "School of Medicine, University of Western Australia, Perth, Australia."), [Stuart R Dalziel](https://pubmed.ncbi.nlm.nih.gov/?term=Dalziel+SR&cauthor_id=42028918)[ 14 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-14 "Departments of Surgery and Pediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.")[ 15 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-15 "Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand."), [Adriana Yock-Corrales](https://pubmed.ncbi.nlm.nih.gov/?term=Yock-Corrales+A&cauthor_id=42028918)[ 16 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-16 "Department of Emergency Medicine, Hospital Nacional de Niños Dr. Carlos Sáenz Herrera, Caja Costarricense del Seguro Social, San José, Costa Rica."), [Ruchi Singh](https://pubmed.ncbi.nlm.nih.gov/?term=Singh+R&cauthor_id=42028918)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-1 "Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-2 "Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia."), [Amanda Williams](https://pubmed.ncbi.nlm.nih.gov/?term=Williams+A&cauthor_id=42028918)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-8 "Murdoch Children's Research Institute, Parkville, VIC, Australia."), [Beata Mickiewicz](https://pubmed.ncbi.nlm.nih.gov/?term=Mickiewicz+B&cauthor_id=42028918)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-9 "Departments of Pediatrics and Emergency Medicine, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada."), [Christopher P Hickey](https://pubmed.ncbi.nlm.nih.gov/?term=Hickey+CP&cauthor_id=42028918)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-3 "Children's Hospital of Philadelphia Pediatric Sepsis Program, Philadelphia.")[ 17 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-17 "Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia."), [Julie C Fitzgerald](https://pubmed.ncbi.nlm.nih.gov/?term=Fitzgerald+JC&cauthor_id=42028918)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-3 "Children's Hospital of Philadelphia Pediatric Sepsis Program, Philadelphia.")[ 17 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-17 "Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia."), [Benjamin L Laskin](https://pubmed.ncbi.nlm.nih.gov/?term=Laskin+BL&cauthor_id=42028918)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-1 "Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-2 "Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia."), [Robert W Hickey](https://pubmed.ncbi.nlm.nih.gov/?term=Hickey+RW&cauthor_id=42028918)[ 18 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-18 "Division of Pediatric Emergency Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh."), [Michelle Eckerle](https://pubmed.ncbi.nlm.nih.gov/?term=Eckerle+M&cauthor_id=42028918)[ 19 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-19 "Department of Pediatrics, University of Cincinnati College of Medicine and Division of Emergency Medicine, Cincinnati Children's Hospital, Cincinnati."), [Waleed Alqurashi](https://pubmed.ncbi.nlm.nih.gov/?term=Alqurashi+W&cauthor_id=42028918)[ 20 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-20 "Children's Hospital of Eastern Ontario, Ottawa.")[ 21 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-21 "Departments of Pediatrics and Emergency Medicine, Faculty of Medicine, University of Ottawa, Children's Hospital of Eastern Ontario Research Institute, Ottawa."), [Elizabeth Alpern](https://pubmed.ncbi.nlm.nih.gov/?term=Alpern+E&cauthor_id=42028918)[ 22 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-22 "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."), [Lilliam Ambroggio](https://pubmed.ncbi.nlm.nih.gov/?term=Ambroggio+L&cauthor_id=42028918)[ 23 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-23 "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."), [Mohamed Badawy](https://pubmed.ncbi.nlm.nih.gov/?term=Badawy+M&cauthor_id=42028918)[ 24 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-24 "Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Children's Medical Center, Dallas."), [Shannon Baumer-Mouradian](https://pubmed.ncbi.nlm.nih.gov/?term=Baumer-Mouradian+S&cauthor_id=42028918)[ 25 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-25 "Department of Pediatrics, Medical College of Wisconsin and Children's Wisconsin, Milwaukee."), [Simon Berthelot](https://pubmed.ncbi.nlm.nih.gov/?term=Berthelot+S&cauthor_id=42028918)[ 26 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-26 "Département de Médecine de Famille et de Médecine d'Urgence, Faculté de Médecine, Université Laval et Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec-Université Laval, Quebec, QC, Canada."), [Lindsay D Clukies](https://pubmed.ncbi.nlm.nih.gov/?term=Clukies+LD&cauthor_id=42028918)[ 27 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-27 "Division of Emergency Medicine, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis."), [Simon Craig](https://pubmed.ncbi.nlm.nih.gov/?term=Craig+S&cauthor_id=42028918)[ 28 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-28 "Paediatric Emergency Department, Monash Medical Centre, Melbourne, VIC, Australia.")[ 29 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-29 "Department of Pediatrics, Sub-Faculty of Clinical and Molecular Medicine, Monash University, Melbourne, VIC, Australia."), [Sarah J Curtis](https://pubmed.ncbi.nlm.nih.gov/?term=Curtis+SJ&cauthor_id=42028918)[ 30 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-30 "Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Alberta Stollery Children's Hospital, Edmonton, Canada.")[ 31 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-31 "Women and Children's Health Research Institute, Edmonton, AB, Canada."), [Adrienne L Davis](https://pubmed.ncbi.nlm.nih.gov/?term=Davis+AL&cauthor_id=42028918)[ 32 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-32 "Division of Emergency Medicine, Department of Pediatrics, Hospital for Sick Children and the Department of Paediatrics, University of Toronto, Toronto."), [Susan Duffy](https://pubmed.ncbi.nlm.nih.gov/?term=Duffy+S&cauthor_id=42028918)[ 33 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-33 "Hasbro Children's Hospital, Brown University Health, Providence, RI."), [Matthew A Eisenberg](https://pubmed.ncbi.nlm.nih.gov/?term=Eisenberg+MA&cauthor_id=42028918)[ 34 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-34 "Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Boston.")[ 35 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-35 "Departments of Pediatrics and Emergency Medicine, Harvard Medical School, Boston."), [Jason G Emsley](https://pubmed.ncbi.nlm.nih.gov/?term=Emsley+JG&cauthor_id=42028918)[ 36 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-36 "IWK Health Centre and Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, Dalhousie University, Halifax NS, Canada."), [Ara Festekjian](https://pubmed.ncbi.nlm.nih.gov/?term=Festekjian+A&cauthor_id=42028918)[ 37 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-37 "Division of Emergency and Transport Medicine, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles.")[ 38 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-38 "Keck School of Medicine, University of Southern California, Los Angeles."), [Shane George](https://pubmed.ncbi.nlm.nih.gov/?term=George+S&cauthor_id=42028918)[ 39 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-39 "Department of Emergency Medicine and Children's Critical Care, Gold Coast University Hospital, Southport, QLD, Australia.")[ 40 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-40 "School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia."), [Rebecca Green](https://pubmed.ncbi.nlm.nih.gov/?term=Green+R&cauthor_id=42028918)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-1 "Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-2 "Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia."), [Karen E Gripp](https://pubmed.ncbi.nlm.nih.gov/?term=Gripp+KE&cauthor_id=42028918)[ 41 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-41 "Section of Pediatric Emergency Medicine, Department of Pediatrics and Child Health, Health Sciences Center Winnipeg Children's Hospital, Winnipeg, MB, Canada.")[ 42 ](https://pubmed.ncbi.nlm.nih.gov/42028918/#full-view-affiliation-42 "Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canad
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