title: The effect of NaCl 0.9% and NaCl 0.45% on sodium, chloride, and acid-base balance in a PICU population.
abstract: OBJECTIVE
  To study the effect of two intravenous maintenance fluids on plasma sodium (Na), and acid-base balance in pediatric intensive care patients during the first 24h of hospitalization.
  
  
  METHODS
  A prospective randomized controlled study was performed, which allocated 233 patients to groups: (A) NaCl 0.9% or (B) NaCl 0.45%. Patients were aged 1 day to 18 years, had normal electrolyte concentrations, and suffered an acute insult (medical/surgical).
  
  
  METHODS
  change in plasma sodium. Parametric tests: t-tests, ANOVA, X(2) statistical significance level was set at α=0.05.
  
  
  RESULTS
  Group A (n=130): serum Na increased by 2.91 (±3.9)mmol/L at 24h (p<0.01); 2% patients had Na higher than 150 mmol/L. Mean urinary Na: 106.6 (±56.8)mmol/L. No change in pH at 0 and 24h. Group B (n=103): serum Na did not display statistically significant changes. Fifteen percent of the patients had Na<135 mmol/L at 24h. The two fluids had different effects on respiratory and post-operative situations.
  
  
  CONCLUSIONS
  The use of saline 0.9% was associated with a lower incidence of electrolyte disturbances.
authors.affiliation: Pediatric Intensive Care Unit, Pediatric Department, Hospital Prof. Doutor Fernando Fonseca EPE, Amadora, Portugal. Electronic address: lenaizabel@gmail.com.
authors.forename: Helena Isabel
authors.initials: HI
authors.lastname: Almeida
authors.affiliation: Pediatric Intensive Care Unit, Pediatric Department, Hospital Prof. Doutor Fernando Fonseca EPE, Amadora, Portugal.
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Mascarenhas
authors.affiliation: Pediatric Intensive Care Unit, Pediatric Department, Hospital Prof. Doutor Fernando Fonseca EPE, Amadora, Portugal.
authors.forename: Helena Cristina
authors.initials: HC
authors.lastname: Loureiro
authors.affiliation: Pediatric Intensive Care Unit, Pediatric Department, Hospital Prof. Doutor Fernando Fonseca EPE, Amadora, Portugal.
authors.forename: Clara S
authors.initials: CS
authors.lastname: Abadesso
authors.affiliation: Pediatric Intensive Care Unit, Pediatric Department, Hospital Prof. Doutor Fernando Fonseca EPE, Amadora, Portugal.
authors.forename: Pedro S
authors.initials: PS
authors.lastname: Nunes
authors.affiliation: Pediatric Intensive Care Unit, Pediatric Department, Hospital Prof. Doutor Fernando Fonseca EPE, Amadora, Portugal.
authors.forename: Marta S
authors.initials: MS
authors.lastname: Moniz
authors.affiliation: Faculty of Medicine, Universidade de Lisboa, Lisbon, Portugal.
authors.forename: Maria Céu
authors.initials: MC
authors.lastname: Machado
mesh_terms: D000136:Acid-Base Equilibrium / Q000187:drug effects*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced / Q000188:drug therapy / Q000378:metabolism; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D015278:Intensive Care Units, Pediatric; D008297:Male; D011446:Prospective Studies; D012964:Sodium / Q000097:blood / Q000378:metabolism*; D012965:Sodium Chloride / Q000378:metabolism / Q000494:pharmacology*
chemical_list: D012965:Sodium Chloride; D012964:Sodium
keywords: Acid–base equilibrium; Chloride; Cloreto; Equilíbrio Ácido-Base; Fluidos de manutenção; Hiponatremia; Hyponatremia; Maintenance fluids; Pediatria; Pediatrics; Sodium; Sódio