A prospective trial comparing isotonic with hypotonic maintenance fluids for prevention of hospital-acquired hyponatraemia
Autor: | Carlos A. Cuello Garcia, Claudia Montserrat Flores Robles |
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Rok vydání: | 2016 |
Předmět: |
Male
Adolescent medicine.medical_treatment Iatrogenic Disease law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law 030225 pediatrics Isotonic Medicine Humans 030212 general & internal medicine Prospective Studies Adverse effect Child Saline business.industry Incidence (epidemiology) Incidence Sodium Infant Hypotonic Solutions Prospective trial Anesthesia Child Preschool Pediatrics Perinatology and Child Health Tonicity Fluid Therapy Administration Intravenous Female Isotonic Solutions business Hyponatremia |
Zdroj: | Paediatrics and International Child Health. :1-7 |
ISSN: | 2046-9055 2046-9047 |
Popis: | Recent literature suggests that hypotonic fluids increase the risk of hospital-acquired hyponatraemia; despite this, hypotonic fluids are widely used.To compare the change in serum sodium following the use of hypotonic (0.3% saline, 0.45% saline) or isotonic (0.9% saline) intravenous (IV) maintenance solutions in hospitalised children.This was a randomised controlled trial. Children aged 3 months to 15 years with medical or surgical disorders were randomised to receive one of three maintenance IV fluids: two hypotonic solutions (3.3% dextrose in 0.3% saline or 5% dextrose in 0.45% saline) and one isotonic solution (5% dextrose in 0.9% saline). The primary outcome was serum sodium levels at 8 hours. Secondary outcomes included the incidence of hospital-acquired hyponatraemia, adverse events attributable to IV solutions and length of hospital stay.151 children were assigned randomly to receive 0.3% saline (n = 49), 0.45% saline (n = 50) or 0.9% saline (n = 52). Baseline characteristics were similar for the three groups. At 8 hours, mean (SD) serum sodium was lower in the hypotonic solutions groups [0.3% saline 134.65 (1.9) mmol/L, 0.45% saline 134.90 (2.3) mmol/L than 0.9% saline 137.98 (2.8) mmol/L] (P 0.0001). The incidence of hospital-acquired hyponatraemia was higher in the hypotonic groups [0.3% saline 10/49 (20.4%), 0.45% saline 11/50 (22%) than 0.9% saline 1/52 (1.9%), P = 0.006). There were no differences in other adverse effects or length of hospital stay between the groups.Hypotonic IV solutions increase the incidence of hospital-acquired hyponatraemia. Isotonic solutions are a safer alternative. |
Databáze: | OpenAIRE |
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