The Clinical and Metabolic Derangements after Using 0.9% Normal Saline as Maintenance Intravenous Fluid in Children

Isotonic fluids like 0.9% normal saline (NS) are recommended for maintenance intravenous fluid (mIVF) therapy in children. However, concerns exist regarding hyperchloremia and its associated complications, particularly in younger children.

The objective of the study was to evaluate the clinical and metabolic effects of 0.9% NS as mIVF in noncritically ill pediatric patients.

This longitudinal study included 80 children aged 1 month to 13 years admitted to a tertiary care center, who received 0.9% NS as mIVF for at least 50% of a 24-h period. Baseline and 48-h clinical and biochemical parameters were recorded and compared.

After 48 h, there was a significant decrease in heart rate, respiratory rate, blood urea, and serum creatinine, and a significant increase in blood pressure, serum sodium, potassium, and chloride (P < 0.05). Hyperchloremia was observed in 7.5% of children, all aged <5 years.

0.9% NS may lead to significant clinical and metabolic changes, particularly hyperchloremia in younger children.