title: Intravenous isotonic fluids induced a positive trend in natraemia in children admitted to a general paediatric ward.
abstract: OBJECTIVE
  Using hypotonic intravenous solutions for baseline fluid needs in paediatric patients on a nil by mouth diet may cause serious complications, including hyponatraemia, cerebral oedema and even death. We analysed the evolution of natraemia and explored any adverse effects on children treated with intravenous isotonic fluids.
  
  
  METHODS
  This was a prospective study of 50 patients consecutively admitted to a general paediatric ward who were treated with isotonic intravenous fluids and on a nil by mouth diet.
  
  
  RESULTS
  The most prevalent diagnosis was acute gastroenteritis (64%). Hyponatraemia, defined as sodium in plasma of <135 mEq/L, affected 22% of the subjects, but none displayed this during the first postadmission analysis at a median of eight hours. Sodium levels changed by an average of +0.64 mEq/L/hour. The subgroup analysis (0.91 versus 0.56 mEq/L/hour, p = 0.02) and multiple linear regression (R(2) = 0.756) showed a greater increase in sodium when patients had hyponatraemia on admission. Iatrogenic hyponatraemia was not detected, but two patients showed mild hypernatraemia and 35% developed clinically insignificant hyperchloraemia.
  
  
  CONCLUSIONS
  Using intravenous isotonic fluids induced a positive trend in natraemia on a general paediatric ward, particularly if patients were hyponatraemic when admitted, and did not induce clinically relevant adverse effects.
authors.affiliation: Department of Pediatrics, General and University Hospital, Castellon, Spain.
authors.forename: Juan Diego
authors.initials: JD
authors.lastname: Toledo
authors.affiliation: Department of Pediatrics, General and University Hospital, Castellon, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Morell
authors.affiliation: Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain.
authors.forename: Maximo
authors.initials: M
authors.lastname: Vento
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007010:Hyponatremia / Q000209:etiology / Q000517:prevention & control*; D007038:Hypotonic Solutions / Q000009:adverse effects; D007552:Isotonic Solutions / Q000009:adverse effects; D008297:Male; D010372:Pediatrics; D011446:Prospective Studies; D012964:Sodium / Q000097:blood*
chemical_list: D007038:Hypotonic Solutions; D007552:Isotonic Solutions; D012964:Sodium
keywords: Intravenous fluids; Isotonic fluids; Paediatric patients; Rehydration; Sodium