Journal on Medical Casereports - BJSTR Journal

Abstract

Most of the guidelines and textbooks are still recommending #hypotonic maintenance fluids for pediatric patients based on #Holliday-Segar method. Maintenance intravenous (IV) fluids are designed to maintain homeostasis. There is risk of iatrogenic#hyponatremia with hypotonic intravenous (IV) maintenance in otherwise normal children. Administration of hypotonic IV fluids is a major risk factor for developing hyponatremia in hospitalized euvolemic children who are dependent upon #parenteral fluid therapy. The risk will increase significantly in those with the risk of Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH). The estimated incidence of clinically significant, symptomatic cases of hospital acquired acute #hyponatremia is relatively low (0.07%). Severe hyponatremia (<120 mmol/l) has been reported to be associated with increase in the cost of stay, morbidity and mortality.Hyponatremia is common in patients with infection (especially severe infection) and pulmonary disease (hypoxemic state). Hyponatremia has been reported in 52% of children with febrile convulsions and 33% of children with #Respiratory syncytialvirus (RSV) bronchiolitis. Surgical patients tended to have a greater fall in plasma sodium level than nonsurgical patients. #Antidiuretic hormone (ADH) concentrations increase 2-4 folds during the operation and remained elevated through the first 24 hours #postoperatively.

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How much salt is sufficient? by Amar Al Shibli in BJSTR