Acute Hyponatremia And Hypernatremia Related To Intravenous Fluid Administration In Hospitalized Children: A Randomized Observational Study

ABSTRACT

Background: Intravenous fluid and electrolyte therapy in most of the acutely ill hospitalized children has beenthe cornerstone of medical practice for a well over 50 years.Objective: To determine optimal maintenance fluid therapy by comparing the incidence of hyponatremia orhypernatremia in hospitalised children.Methods: A prospective Randomized study done in PICU in patients admitted to paediatric emergency. The studywas conducted between September 2007 to May 2008. Children of age group 1 month to 16 years were included.The fluid groups were divided into four groups. SPSS version 18 was used for analysis.Results: The mean age in group I is 4.42, in group 2 is 3.84, in group 3 is 3.67 and in group 4 is 4.45. The meanserum sodium levels in fluid group 1 is 137.4 mmol/L, in fluid group II 138.2 mmol/L, in fluid group III is 138.9mmol/L and fluid group IV is 137.8 mmol/L. After initiating maintenance fluid therapy serum sodium levelschanged in each group. As we can see in group 1 mean serum sodium level at the start of the therapy is 137.43mmol/L and after 24 hours of hypotonic fluid infusion it reduced to 135.4 mmol. 69 patients had hyponatremiaand 44 had hypernatremia.Conclusion: Amount of free fluid in the IV maintenance fluid can be factor in causing hypernatremia. Caution iswarranted to guard off a rapid fall of serum sodium level.