Table 7.
Relationship between intravenous fluid composition and development of hyponatremia (2003–2009)
| Authors | Study design | Number | Outcome |
|---|---|---|---|
| Hoorn et al. 2004 [123] | Retrospective. Incidence of acute (48 h) hospital-acquired hyponatremia (SNa < 136 mEq/L) in children presenting to the ED with a normal SNa | 432 | 40 patients (10%) developed acute hyponatremia with a fall in SNa from 139 ± 3 to 133 ± 2 mEq/L in 19 ± 10 h. All received hypotonic fluids |
| Neville et al. 2005 [127] | Prospective. Change in SNa at 4 h in normonatremic children with gastroenteritis receiving 0.45% NaCl | 25 | Fall in SNa from 138 ± 1.6 to 135 ± 2 mEq/L |
| Mehta et al. 2005 [128] | Prospective. Change in SNa at 24 h in jaundiced neonates receiving 0.18% NaCl | 37 | Fall in SNa from 141 ± 5 to 134 ± 4 mEq/L |
| Neville et al. 2006 [129] | Prospective randomized trial. Change in SNa at 4 h in normonatremic children with gastroenteritis receiving either 0.45% NaCl or 0.9% NaCl | 65 | Fall in SNa in the 0.45% NaCl group from 137 ± 7 to 135 ± 1.8 mEq/L |
| SNa unchanged in 0.9% NaCl group, 137 ± 2.2 to 138 ± 2.9 mEq/L | |||
| Dearlove et al. 2006 [130] | Retrospective. Incidence of hyponatremia in children following appendectomy; 87% received 0.45% NaCl | 51 | 32% incidence of hyponatremia (127–133 mEq/L) |
| Stewart and McGrath 2007 [131] | Prospective. Change in SNa in children following appendectomy treated with 0.45% NaCl or 0.9% NaCl | 30 | Fall in SNa in the 0.45% NaCl group by 1.2 mEq/L/day |
| Increase in SNa in the 0.9% NaCl group by 1.7 mEq/L/day | |||
| Coulthard et al. 2007 [132] | Retrospective. Change in SNa in children following spinal surgery treated with 0.3% NaCl at 2/3 maintenance or full maintenance with Hartmann’s solution (Na = 131 mEq/L) | 59 | Fall in SNa in 0.3% NaCl group from 140.7 ± 2.4 to 135.5 ± 2.5 |
| Fall in SNa in Hartmans’s group from 140.1 ± 2.5 to 137.6 ± 2.8 | |||
| Yung and Keely 2009 [72] | Prospective randomized trial. Change in SNa at 12–24 h in children admitted to the ICU randomized to either 0.18% NaCl or 0.9% NaCl at 2/3 or full maintenance rate | 50 | Fall in SNa in 0.18% NaCl group by 3 mEq/L and 4.9 mEq/L, respectively |
| Increase in SNa in the 0.9% NaCl group by 0.2 and 1.5 mEq/L, respectively | |||
| Armon et al. 2008 [124] | Cross-sectional survey. Incidence of hyponatremia (SNa < 135 mEq/L) in children receiving hypotonic fluids one day; 77% received hypotonic fluids | 86 | 24% incidence of hyponatremia |
| Au et al. 2008 [58] | Retrospective. Incidence of moderate hyponatremia (SNa < 130 mEq/L) within 24 h in postoperative children admitted to the ICU receiving hypotonic fluids (Na < 130 mEq/L) or near isotonic fluids (Na ≥ 130 mEq/L) | 145 | 12.9% incidence of moderate hyponatremia in the hypotonic group |
| 3.4% incidence in moderate hyponatremia in the near isotonic group | |||
| Montonana et al. 2008 [73] | Prospective randomized. Incidence of hyponatremia (SNa < 135 mEq/L) within 24 h in postoperative children admitted to the ICU receiving either hypotonic fluids (Na < 100 mEq/L) or isotonic fluid (Na + K = 155 mEq/L) | 122 | 20.6% incidence of hyponatremia in the hypotonic group |
| 5.1% incidence of hyponatremia in the isotonic group | |||
| Singhi and Jayashre 2009 [133] | Prospective observational. Incidence of hyponatremia (SNa <130) in children admitted to the ICU receiving 0.18% NaCl | 38 | 31% incidence of hyponatremia |
SNa serum sodium, ED emergency department, NaCl sodium chloride, Na sodium, ICU intensive care unit