• A Mathur, T Duke, R Kukuruzovic, and M South.
• Dept of Paediatrics, Royal Chldren's Hospital, Flemington Rd, Parkville, Melbourne, Victoria, Australia, 3052.
• Cochrane Db Syst Rev. 2004 Jan 1(2):CD004169.

BackgroundHypotonic saline is commonly used as maintenance fluid in the management of acute infections. In recent years use of a hypotonic saline has been associated with adverse outcomes. To reduce the rates of adverse outcomes, use of isotonic saline as maintenance fluid has been suggested.ObjectivesTo asses adverse events and benefits associated with infusion of hypotonic saline compared to isotonic saline solutions in the management of acute infections.Search StrategyWe searched MEDLINE, EMBASE, The Cochrane Controlled Trials Register, current controlled trials and the Specialised register of the Injuries Group.Selection CriteriaRandomised trials comparing hypotonic saline to isotonic saline in the management of acute infections.Data Collection And AnalysisThree reviewers independently evaluated all potentially relevant articles, examined each study for possible inclusion and assessed the methodology quality using the Cochrane guidelines.Main ResultsNo trials met our inclusion criteria.Reviewers' ConclusionsWe found no randomised controlled evidence to show that use of isotonic saline as a maintenance fluid instead of a hypotonic saline will lead to an improvement in outcomes. Randomised trials with adequate design and sample sizes are needed to evaluate the possible advantages and risks of using isotonic saline as maintenance fluid.

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