Is hyperchloremia following sepsis resuscitation with 0.9% saline clinically important?

The authors of the article titled “Balanced salt solution versus normal saline solution as initial fluid resuscitation in pediatric septic shock: a randomized, double-blind controlled trial”, published in Critical Care and Shock, should be congratulated for design and conduct of a randomized, double-blind clinical trial in severely unwell children with sepsis. The patient population included in the study was severely unwell: all patients enrolled went on to require inotropic therapy, and overall mortality was 24.6%. This stands in contrast to industrialized countries, where inotrope use and death from septic shock are significantly lower. The generalizability of findings between regions…