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Introducing isotonic fluids into pediatric oncology.
Amadeus T Heinz1, Thomas Eichholz1, Manon Queudeville1
1Department of Hematology and Oncology, University Children's Hospital Tübingen, Tübingen, Germany.
Pediatric Hematology and Oncology
|November 9, 2021
Summary
Switching to isotonic fluids in pediatric oncology reduced hospital-acquired hyponatremia without causing hypernatremia. This change in fluid management shows promise for improving patient safety in cancer care.
Area of Science:
- Pediatric Oncology
- Nephrology
- Internal Medicine
Background:
- Hypotonic fluids are standard in pediatric oncology but linked to hospital-acquired hyponatremia.
- Limited data exists on the risks and benefits of isotonic fluids in this patient population.
Purpose of the Study:
- To investigate the impact of replacing hypotonic fluids with isotonic fluids in a pediatric oncology unit.
- To evaluate changes in electrolyte levels, fluid balance, acid-base status, and kidney function.
Main Methods:
- Retrospective analysis comparing laboratory disorders before and after the fluid change.
- Examination of electrolyte disturbances, fluid- and acid-base balance, and kidney function.
Main Results:
- Isotonic fluids significantly reduced the incidence of hyponatremia.
- No cases of hypernatremia were observed.
- Increased potassium and bivalent cation levels, reduced acidosis risk, and increased alkalosis due to furosemide use.
- Acute kidney injury rates did not increase.
Conclusions:
- Isotonic fluids effectively reduce hospital-acquired hyponatremia in pediatric oncology without inducing hypernatremia.
- Further research is needed to fully understand the effects on fluid balance.
- Balanced fluids contribute to measurable changes in bivalent cation and buffering anion intake.
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