• Ahmar Shamim, Kamran Afzal, and S Manazir Ali.
• Department of Pediatrics, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India. Correspondence to: Dr Ahmar Shamim, Assistant Professor, Mahatma Gandhi Mission Medical College, Navi Mumbai, Maharashtra, India. ahmar_shamim@yahoo.com.
• Indian Pediatr. 2014 Dec 1;51(12):969-74.

ObjectiveTo compare the safety and efficacy of isotonic versus hypotonic maintenance fluid in children.DesignRandomized controlled trial.SettingTertiary-level teaching hospital.Participants60 children (age 0.5 to 12 years) who were admitted and anticipated to receive intravenous fluid for the next 48 hours.InterventionHypotonic fluid (Standard maintenance volume as 0.18% NaCl in 5% dextrose) or Isotonic fluid (60% Standard maintenance volume as 0.9% NaCl solution in 5% dextrose).Outcome MeasuresPrimary: Incidence of hyponatremia. Secondary: Serum sodium, serum osmolality, blood sugar, blood urea, serum creatinine, serum potassium, serum chloride, pH, urine output, change in weight, morbidity and death.ResultsAt 24 hours, hyponatremia was noted in 7 (24%) patients in the isotonic and 16 (55%) in hypotonic group (P=0.031). At 48 hours, hyponatremia was noted in 4 (14%) and 13 (45%) patients in isotonic and hypotonic group, respectively (P=0.02). There was significant change in sodium levels in both isotonic (P=0.036) and hypotonic (P<0.001) intervention groups. The peak fall in mean serum sodium level was noted at 24 hours (-6.5, 95%CI: -3.5, -9.6 mEq/L; P<0.001) in hypotonic group. In isotonic group, there was significant increase between 24 and 48 hours (4.3, 95% CI: 0.1, 8.4 mEq/L; P=0.04).ConclusionsReduced volume isotonic fluid results in fewer episodes of hyponatremia than hypotonic fluid in sick children during the first 48 hours of intravenous fluid therapy.

16 keywords...

hide…