[Intravenous fluid therapy in children]

Area of Science:

• Pediatric Medicine
• Clinical Practice
• Fluid Management

Background:

• Danish hospitals routinely prescribe hypotonic maintenance fluids (20-40 mmol/l sodium) for pediatric patients with reduced intake.
• Evidence indicates a link between hypotonic fluids and potentially fatal hyponatremia in children.
• This practice poses a significant risk of neurological damage.

Purpose of the Study:

• To recommend a shift in fluid management protocols for pediatric patients.
• To advocate for the availability of isotonic maintenance fluids in all Danish hospitals.
• To mitigate the risk of hyponatremia and associated neurological complications.

Main Methods:

• Review of existing evidence on fluid therapy in pediatric care.
• Analysis of the risks associated with hypotonic fluid administration.
• Formulation of recommendations for standardized isotonic fluid use.

Main Results:

• Hypotonic maintenance fluids are associated with increased risk of hyponatremia in children.
• Isotonic solutions (140-154 mmol/l sodium, 5% glucose) are identified as a safer alternative.
• Addition of potassium (20 mmol/l) may be considered for specific pediatric needs.

Conclusions:

• Standardizing the use of isotonic maintenance fluids is crucial for pediatric patient safety.
• Implementation of these fluids can prevent hyponatremia and neurological sequelae.
• A change in practice is urgently needed in Danish pediatric departments.