Isotonic Sodium Solutions Are Best for Maintenance Intravenous Therapy

Hyponatremia occurred more than twice as often in children given hypotonic solutions than in children given isotonic hydrating fluids.

For nearly half a century, hypotonic fluids have been recommended as maintenance fluids, although recent study findings show that isotonic hydrating fluids might be superior. In a double-blind trial, investigators randomized 641 hospitalized children aged ≥3 months to receive intravenous hydration with isotonic fluids (140 mmol/L sodium, 98 mmol/L chloride) or hypotonic fluids (77 mmol/L sodium, 77 mmol/L chloride).

Twelve children in the group receiving isotonic fluids developed hyponatremia (serum sodium <135 mmol/L) compared with 35 children in the hypotonic fluid group (odds ratio, 0.31; P=0.001). The volume of infused fluid and the number of postoperative patients were similar between groups. Hyponatremia developed within the first 6 ho…

Reviewing Author

F. Bruder Stapleton, MD

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Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

Isotonic Sodium Solutions Are Best for Maintenance Intravenous Therapy

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Reviewing Author