Evidence map›Paper›PMID 41826663›Full record

ReviewJournal of perinatology : official journal of the California Perinatal Association2026

Balanced fluid bolus: Should we prefer balanced crystalloids over "normal" saline?

Kelsey Carrigan, Satyan Lakshminrusimha

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In one paragraph

Review in Journal of perinatology : official journal of the California Perinatal Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Kelsey CarriganDepartment of Pediatrics, Division of Neonatology, UC Davis Children's Hospital, Sacramento, CA, USA. kcarrigan@health.ucdavis.edu.ORCID http://orcid.org/0009-0001-6680-0989
Satyan LakshminrusimhaDepartment of Pediatrics, Division of Neonatology, UC Davis Children's Hospital, Sacramento, CA, USA.ORCID http://orcid.org/0000-0001-6098-2155

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A fluid bolus is administered to correct hypoperfusion, hypotension, and metabolic acidosis for resuscitation at birth or in the neonatal intensive care unit (NICU). However, there is a lack of evidence-based support for any particular fluid choice. The most used intravenous fluid is 0.9% sodium chloride or "normal saline" (NS). There is a growing body of evidence that NS is associated with hyperchloremic metabolic acidosis and acute kidney injury. Balanced crystalloid solutions such as lactated Ringer's solution and solutions with a more physiological composition similar to plasma may offer some advantages compared to NS based on adult literature. Here we discuss indications and challenges with the use of balanced crystalloids and propose a practical approach to fluid choice in the NICU. Further research is needed to better understand indications for and optimal fluid therapy to correct hypoperfusion and metabolic acidosis in neonates.

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.