Abstract

AIM
Study the influence of hypotonic (HT) and isotonic (IT) maintenance fluids in the incidence of dysnatraemias in critically ill children.
METHODS
Prospective, randomized study conducted in three paediatric intensive care units (PICU). One hundred and twenty-five children requiring maintenance fluid therapy were included: 62 received HT fluids (50-70 mmol/L tonicity) and 63 IT fluids (156 mmol/L tonicity). Age, weight, cause of admission, sodium and fluid intake, and diuresis were collected. Blood electrolytes were measured on admission, 12 and 24 h later.
RESULTS
Blood sodium levels at 12 h were 133.7±2.7 mmol/L in HT group vs. 136.8±3.5 mmol/L in IT group (p=0.001). Adjusted for age, weight and sodium level at PICU admission, the blood sodium values of patients receiving HT fluids decrease by 3.22 mmol/L (CI: 4.29/2.15)(p=0.000). Adjusted for age, weight and hyponatraemia incidence at admission, patients receiving HT fluids increased the risk of hyponatraemia by 5.8-fold (CI: 2.4-14.0) during the study period (p=0.000).
CONCLUSIONS
Hypotonic maintenance fluids increase the incidence of hyponatraemia because they decrease blood sodium levels in normonatraemic patients. IT maintenance fluids do not increase the incidence of dysnatraemias and should be considered as the standard maintenance fluids.

Links

Publisher Full Text

Authors

Rey C, Los-Arcos M, Hernández A, Sánchez A, Díaz JJ, López-Herce J

Institution

Paediatric Intensive Care Unit, Department of Paediatrics, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Asturias, Spain. corsino.rey@sespa.princast.es

Source

Acta paediatrica (Oslo, Norway : 1992) 100:8 2011 Aug pg 1138-43

MeSH

Child
Critical Illness
Fluid Therapy
Humans
Hyponatremia
Hypotonic Solutions
Infusions, Intravenous
Intensive Care Units, Pediatric
Isotonic Solutions

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

21352357