Hospital-Acquired Hyponatremia in Children Following Hypotonic Versus Isotonic Intravenous Fluids Infusion

Overview

Journal Children (Basel)

Specialty Health Services

Date 2018 Oct 4

PMID 30279348

Citations 3

Authors

Spyridon A Karageorgos

Panagiotis Kratimenos

Ashley Landicho

Joshua Haratz

Louis Argentine

Amit Jain

Andrew D McInnes

Margaret Fisher

Ioannis Koutroulis

Affiliations

Soon will be listed here.

Abstract

Hypotonic solutions have been used in pediatrics for maintenance of intravenous (IV) hydration. However, recent randomized control trials and cohort studies have raised significant concerns for association with hospital-acquired hyponatremia (HAH). The study aimed to assess whether the use of hypotonic parenteral solutions (PS) compared with isotonic PS is associated with increased HAH risk in children with common pediatric conditions. Retrospective chart review of 472 patients aged 2 months to 18 years who received either isotonic or hypotonic PS as maintenance fluids. Administration of hypotonic PS was associated with a four-fold increase in risk of developing HAH in the univariate analysis, (unadjusted odds ratio (OR) = 3.99; 95% confidence interval (CI): 1.36⁻11.69, 0.01). Hypotonic PS were associated with HAH ( = 0.04) when adjusted for the level of admission serum CO₂. There was a mean decrease of serum sodium of 0.53 mEq/L in the hypotonic group compared to the mean increase of 4.88 mEq/L in the isotonic group. These data suggest that hypotonic PS are associated with HAH in children admitted for common pediatric conditions. Isotonic PS should be considered as a safer choice for maintenance fluid hydration.

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