IV fluid choices in children: have we found the solution?
Journal Title: Jornal de Pediatria - Year 2015, Vol 91, Issue 5
Abstract
There have been at least 15 randomized controlled trials (RCTs) published on the isotonic versus hypotonic maintenance fluid debate in the last decade, the most recent of which was the trial conducted by Valadão et al.,1 published in this issue of Jornal de Pediatria. Based on a concern that children undergoing surgery are at particular risk of hospital-acquired hyponatremia, these investigators conducted a single center, double-blinded RCT comparing isotonic (150meq/L or essentially a 0.9% NaCl solution) to a 30meq/L (0.2% NaCl) hypotonic solution in children undergoing appendectomy, from the time of admission until 48h post-operatively. With a total of 50 patients included in their per protocol analyses (23 and 27 in each arm, respectively), the authors did not find any statistically significant difference in serum sodium in both groups at 24 or 48h. They also did not observe any differences in the secondary outcomes of hypervolemia and other electrolyte disturbances. The authors therefore concluded that both hypotonic and isotonic solutions are appropriate for maintaining intravenous fluid choices in children undergoing appendectomy.
Authors and Affiliations
Karen Choong
Keywords
Related Articles
- EP ID EP555467
- DOI 10.1016/j.jped.2015.05.001
- Views 43
- Downloads 0
Prospective cohort analyzing risk factors for chronic kidney disease progression in children
Objective To identify risk factors for chronic kidney disease progression in Brazilian children and to evaluate the interactions between factors. Methods This was a multicenter prospective cohort in São Paulo, involving...
One-year observational study of palivizumab prophylaxis on infants at risk for respiratory syncytial virus infection in Latin America
Objective This study aims to describe real world palivizumab use and effectiveness in high-risk Latin American infants and young children. Method Prospective, multicenter observational study with infants at risk for sev...
IL-6, TNF-α, IL-10, and nutritional status in pediatric patients with biliary atresia
Objectives The objective of the present study is to evaluate whether IL-6, TNF-α, IL-10 are associated with nutritional status in patients with cirrhosis secondary to biliary atresia and compare to healthy controls. Met...
Pediatric abdominal non-Hodgkin's lymphoma: diagnosis through surgical and non-surgical procedures
Objective To describe the success rate and the complications after procedures to diagnose abdominal non-Hodgkin's lymphoma in children and adolescents. Methods A retrospective cross-sectional study was conducted with a...
Protective effects of human milk antimicrobial peptides against bacterial infection
Breast-feeding provides the nursing infant with a plethora of molecules evolved to optimally develop the infant's tissues and organs. Human milk contains numerous bioactive molecules that modulate the immune system as we...