©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
World J Clin Pediatr. Mar 9, 2026; 15(1): 109864
Published online Mar 9, 2026. doi: 10.5409/wjcp.v15.i1.109864
Published online Mar 9, 2026. doi: 10.5409/wjcp.v15.i1.109864
Early inotropic support without fluid bolus vs standard resuscitation in pediatric septic shock: A randomized controlled trial
Swasti Keshri, Anil K Goel, Samreen Yusuf, Division of Pediatrics Emergency Medicine, Department of Pediatrics, All India Institute of Medical Sciences, Raipur 492099, Chhattīsgarh, India
Ankit Kumar Garg, Department of Orthopedics, All India Institute of Medical Sciences, Raipur, 492099, Chhattīsgarh, India
Varun Anand, Department of Pediatrics, All India Institute of Medical Sciences, Raipur 492099, Chhattīsgarh, India
Sanosh Kumar Rathia, Department of Trauma and Emergency, All India Institute of Medical Sciences Raipur, Raipur 492099, Chhattīsgarh, India
Co-first authors: Swasti Keshri and Anil K Goel.
Author contributions: Keshri S and Goel AK contributed to the concept design, literature search, and manuscript preparation and final approval; Yusuf S and Garg AK contributed to data capture and manuscript editing; Anand V and Rathia SK contributed to figure and table design and data analysis; All authors read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institute Ethical Committee AIIMS Raipur, No. AIIMSRPR/IEC/2021/722, February 16, 2021.
Clinical trial registration statement: This study is registered at ctri.nic.in. CTRI Registration, No. Trial REF/2021/04/033112, April 26, 2021.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest to disclose.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Data sharing statement: The datasets generated and analyzed during the current study are not publicly available because individual privacy could be compromised. However, they are available from the corresponding author on reasonable request.
Corresponding author: Anil K Goel, Professor, Division of Pediatrics Emergency Medicine, Department of Pediatrics, All India Institute of Medical Sciences, GE Road Raipur, Raipur 492099, Chhattīsgarh, India. akgoel@aiimsraipur.edu.in
Received: May 26, 2025
Revised: June 21, 2025
Accepted: October 23, 2025
Published online: March 9, 2026
Processing time: 286 Days and 19.8 Hours
Revised: June 21, 2025
Accepted: October 23, 2025
Published online: March 9, 2026
Processing time: 286 Days and 19.8 Hours
Core Tip
Core Tip: Recent surviving sepsis guidelines showed better outcomes when fluid boluses were restricted. This open-label study in children aged 1 month to 14 years who were hospitalized for septic shock were randomized into two groups: Group I receiving early inotropes without fluid bolus; and Group F receiving fluid bolus. There were no statistically significant differences in the initial inotropic support (vasoactive inotropic support score), the total duration of ventilation, total length of hospital stay, mortality at 48 h, or overall mortality between the two groups. Patients with hypotensive shock who received fluid boluses had significantly higher 48-h mortality.