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Administration of lactated Ringer's within 24 hours before Sepsis-3 onset is associated with lower 28-day mortality in adult patients with sepsis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

September 3, 2026SAGE Open MedicineOpen Access

Timing of lactated Ringer’s administration relative to Sepsis-3 diagnosis and 28-day mortality: A retrospective propensity score-matched cohort study

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Authors

YHYujie HuangSoochow University JZJiayue ZouSoochow University

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Implication

Retrospective cohort study reveals lower 28-day mortality with pre-diagnosis lactated Ringer's administration in sepsis, suggesting potential benefits of early balanced crystalloid resuscitation.

Key Points

To evaluate the association between the timing of lactated Ringer's administration relative to Sepsis-3 diagnosis and 28-day all-cause mortality in critically ill adults.
Conducted a retrospective cohort study using the MIMIC-IV database to analyze adult ICU patients meeting Sepsis-3 criteria stratified by fluid timing relative to onset.
Performed 1:1 propensity score matching between patients receiving lactated Ringer’s within 24 hours prior to sepsis onset (Group B) and unexposed controls (Group D; N=3,876 total; 1,938 per arm).
Estimated 28-day all-cause mortality using multivariable Cox regression, pre-onset fluid sensitivity analyses, and a 24-hour ICU-admission landmark analysis.
Pre-onset lactated Ringer's administration within 24 hours before Sepsis-3 diagnosis was significantly associated with decreased 28-day all-cause mortality after multivariable adjustment.
The mortality benefit persisted across sensitivity analyses adjusting for pre-onset elective surgery, 24-hour baseline fluid volume, and in a 24-hour landmark cohort.
Kidney outcomes were mixed: overall acute kidney injury occurred more frequently with pre-onset exposure, but KDIGO stage 3 injury and renal replacement therapy were less frequent.

Cite This Study

Huang et al. (2026) studied this question.

synapsesocial.com/papers/6a9935a0636c6408cfa7df96 https://doi.org/10.1177/20503121261481481

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Implication

Retrospective cohort study reveals lower 28-day mortality with pre-diagnosis lactated Ringer's administration in sepsis, suggesting potential benefits of early balanced crystalloid resuscitation.

Timing of lactated Ringer’s administration relative to Sepsis-3 diagnosis and 28-day mortality: A retrospective propensity score-matched cohort study

Discussion

Member takes

Implication

Key Points

Cite This Study

Timing of lactated Ringer’s administration relative to Sepsis-3 diagnosis and 28-day mortality: A retrospective propensity score-matched cohort study

Discussion

Member takes

Implication

Key Points

Cite This Study

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