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  1. Home
  2. Comparison Of Serum Sodium Levels Following Intravenous Administration Of Isotonic And Hypotonic Solutions In Young Children: A Randomized Controlled Trial.
  1. Home
  2. Comparison Of Serum Sodium Levels Following Intravenous Administration Of Isotonic And Hypotonic Solutions In Young Children: A Randomized Controlled Trial.

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Comparison of Serum Sodium Levels Following Intravenous Administration of Isotonic and Hypotonic Solutions in Young

Nisara Chongcharoen1, Yupaporn Amornchaichareonsuk2, Suwanna Pornrattanarungsi3

  • 1Department of Pediatrics, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand.

Pediatric Reports
|November 24, 2025

View abstract on PubMed

Summary
This summary is machine-generated.
Keywords:
childrenhyponatremiahypotonic solutionsisotonic solutionsmetabolic acidosis

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In pediatric patients under five, isotonic intravenous fluids (IVFs) better maintained serum sodium levels compared to hypotonic IVFs within 24 hours. This study found no increased risk of complications with isotonic fluids.

Area of Science:

  • Pediatric critical care medicine
  • Intravenous fluid therapy
  • Electrolyte balance

Background:

  • Intravenous fluid (IVF) administration is common in pediatric patients.
  • The choice between isotonic and hypotonic fluids can impact electrolyte balance.
  • Understanding the effects of different IVF solutions on serum sodium is crucial for patient safety.

Purpose of the Study:

  • To compare the effects of isotonic versus hypotonic intravenous fluids (IVFs) on serum sodium (S Na) levels at 24 hours post-administration.
  • To evaluate the incidence of dysnatremia and hyperchloremic metabolic acidosis in pediatric patients receiving different IVF solutions.

Main Methods:

  • A double-blind, randomized controlled trial was conducted involving children aged 3 months to 5 years.
  • Patients were assigned to receive either isotonic (D5 0.9% NaCl) or hypotonic (D5 0.45% NaCl) IVFs.
  • Serum electrolytes and blood gas levels were monitored at baseline, 24 hours, and 48 hours.
  • Main Results:

    • The change in serum sodium at 24 hours was significantly greater with isotonic fluids (2.97 mmol/L) compared to hypotonic fluids (2.19 mmol/L).
    • No significant hyponatremia or hypernatremia occurred in either group.
    • The incidence of hyperchloremic metabolic acidosis and other complications were similar between the groups.

    Conclusions:

    • Isotonic IVFs may be preferable for pediatric patients under five on general wards, particularly within the first 24 hours.
    • Isotonic fluids appear to maintain serum sodium levels effectively without increasing risks of fluid overload or electrolyte complications.
    • Further research may support isotonic fluids as a standard for specific pediatric populations.