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The long-honored recommendation to administer hypotonic intravenous (IV) fluids for maintenance fluid replacement in hospitalized children has recently been challenged because of a possible association with hyponatremia. Investigators examined risk for hyponatremia in a retrospective electronic medical record review of 1048 hospitalized children (2009–2011) with normal serum sodium values at admission; 64% of children received hypotonic maintenance IV fluids (1/4–1/2 normal saline), and 36% received isotonic maintenance IV fluids (normal saline) at admission.
Overall, 35% of children developed hyponatremia (serum sodium <135 mEq/L). In analysis adjusted for baseline differences between the two groups, significantly more children who received…