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Isotonic saline solution as maintenance intravenous fluid therapy to prevent acquired hyponatremia in hospitalized

Josélia T L Alves1, Eduardo J Troster, Carlos Augusto C de Oliveira

  • 1Médica pediatra. Especialização, Terapia Intensiva Pediátrica, Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP. joseliatramontin@hotmail.com

Jornal De Pediatria
|December 16, 2011
PubMed

Insights

Hypotonic saline solutions increase hyponatremia risk in hospitalized children. Isotonic fluids offer protection against hyponatremia without significant adverse effects, suggesting a need to reconsider traditional fluid therapy recommendations.

Area of Science:

  • Pediatric Medicine
  • Nephrology
  • Intravenous Fluid Therapy

Background:

  • Hospitalized children are susceptible to hyponatremia.
  • Hypotonic saline solutions are a primary risk factor for iatrogenic hyponatremia.
  • Traditional fluid therapy guidelines may require reevaluation.

Purpose of the Study:

  • To assess the risk of hyponatremia with hypotonic saline maintenance fluids in children.
  • To determine if isotonic fluids prevent acquired hyponatremia.
  • To evaluate the safety of isotonic solutions regarding hypernatremia and fluid overload.

Main Methods:

  • Literature review of PubMed, EMBASE, and Cochrane Library databases.
  • Inclusion of references from selected studies.
  • Timeframe: January 1969 to July 2011.

Main Results:

  • Hypotonic saline is a significant risk factor for hyponatremia in hospitalized children.
  • Isotonic saline solutions demonstrate a protective effect against hyponatremia.
  • No significant adverse effects like fluid overload or hypernatremia were observed with isotonic solutions.

Conclusions:

  • Current recommendations for maintenance fluid therapy in children, such as the Holliday and Segar method, should be reconsidered.
  • Isotonic fluid therapy appears safer and more effective in preventing hyponatremia.
  • Evidence supports a shift towards isotonic solutions for pediatric maintenance fluid therapy.
Abstract

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