Normal Saline Versus Ringer's Lactate for Initial Fluid Resuscitation in Sepsis

Inclusion Criteria: * Adult male or female patients (≥18 years of age) presenting to the emergency department. * Diagnosed or suspected sepsis secondary to an infectious cause. * Provision of written informed consent by the patient, or if the patient is unable to consent, by a first-degree relative or legally authorized representative. Exclusion Criteria: * Age under 18 years old. * Pregnant women. * Informed consent was not obtained from the patient or their first-degree relative/legal guardian. * Patients who are receiving cardiopulmonary resuscitation (CPR) or who require endotracheal intubation at the time of presentation. * Patients with severe volume depletion unrelated to sepsis (e.g., diabetic ketoacidosis, burns, or active gastrointestinal bleeding). * Patients with severe hyperkalemia (serum potassium level of at least 6.5 mmol/L with ECG changes). * Patients with hypotension that is not related to sepsis (e.g., active hemorrhage or intracranial bleeding). * Patients with clinical signs of pulmonary edema or congestive heart failure. * Cases in which the treating physician determines that one isotonic crystalloid (Ringer's lactate or 0.9% NaCl) is clearly superior to the other due to clinical condition or comorbidities. * Cases in which the treating physician anticipates that fluid therapy might be delayed due to study participation. * Patients requiring immediate hospital or ICU admission before completion of initial emergency department resuscitation. * Patient…