title: How to select optimal maintenance intravenous fluid therapy.
abstract: Hyponatraemia is the commonest electrolyte abnormality in hospitalized patients. If the plasma sodium concentration (P(Na)) declines to approximately 120 mM in <48 h, brain cell swelling might result in herniation, with devastating consequences. The volume and/or the composition of fluids used for intravenous therapy often contribute to the development of acute hyponatraemia. Our hypothesis is that the traditional calculation of the daily loss of insensible water overestimates this parameter, leading to an excessive daily recommended requirement for water. We offer suggestions to minimize the risk of iatrogenic hyponatraemia.
authors.affiliation: Renal Division, St. Michael's Hospital, University of Toronto, Toronto, Canada.
authors.forename: M A S
authors.initials: MA
authors.lastname: Shafiee
authors.forename: D
authors.initials: D
authors.lastname: Bohn
authors.forename: E J
authors.initials: EJ
authors.lastname: Hoorn
authors.forename: M L
authors.initials: ML
authors.lastname: Halperin
mesh_terms: D001834:Body Water / Q000502:physiology; D002940:Circadian Rhythm / Q000502:physiology; D004573:Electrolytes / Q000378:metabolism; D004734:Energy Metabolism / Q000502:physiology; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007010:Hyponatremia / Q000209:etiology / Q000517:prevention & control*; D007038:Hypotonic Solutions / Q000009:adverse effects / Q000627:therapeutic use; D007049:Iatrogenic Disease / Q000517:prevention & control; D007262:Infusions, Intravenous; D008168:Lung / Q000502:physiology; D009994:Osmolar Concentration; D012964:Sodium / Q000097:blood; D014556:Urine / Q000502:physiology; D014870:Water Loss, Insensible / Q000502:physiology
chemical_list: D004573:Electrolytes; D007038:Hypotonic Solutions; D012964:Sodium