The IWK Emergency Department participated in the PRoMPT BOLUS trial, a landmark international study comparing outcomes in children receiving fluid resuscitation for suspected septic shock using either balanced fluids or 0.9% saline. The findings from the PRoMPT BOLUS trial, were recently presented at the 2026 Pediatric Academic Societies Meeting and published in The New England Journal of Medicine, https://www.nejm.org/doi/10.1056/NEJMoa2601969

This large international study was conducted across 47 sites within major research networks, including Pediatric Emergency Research Canada (PERC), the Pediatric Emergency Care Applied Research Network (PECARN) in the United States, and the Pediatric Research in Emergency Departments International Collaborative (PREDICT) in Australia and New Zealand, as well as an additional site in Costa Rica.

A total of 9,041 children aged 2 months to under 18 years were enrolled between August 2020 and October 2025. The results demonstrated no significant difference in the incidence of death, new renal replacement therapy, or persistent kidney dysfunction between patients treated with balanced fluids (such as lactated Ringer’s or Plasma-Lyte) and those receiving 0.9% saline. Although some biochemical differences were observed, specifically higher chloride levels in the saline group and higher lactate levels in the balanced fluid group, these did not translate into clinically meaningful differences in patient outcomes.