ABSTRACT
OBJECTIVE: There is no study evaluating the effect on plasma osmolality of both fluid tonicity and high fluid rate at the same time. The aim of this experimental study was to determine the change in the plasma osmolality by different fluid tonicity and rate, and to suggest the safest and the most appropriate fluids based on the plasma osmolality for medical situations requiring fluid therapy with high or maintenance rates. MATERIALS AND METHODS: The rats were randomly divided into seven groups (six rats in each group): [D5] D5 administered at 100 ml/kg/24h; [D5150] D5 administered at 150 ml/kg/24h; [D5(½)100] D5 0.45% NaCl administered at 100 ml/kg/24h; [D5(½)150] D5 0.45% NaCl administered at 150 ml/kg/24h; [D5(1)100] D5 0.9% NaCl administered at 100 ml/kg/24h; [D5(1)150] D5 0.9% NaCl administered at 150 ml/kg/24h; [Control group] non-treated control rats. Intracardiac blood samples were collected from all the groups at the end of 24 h. RESULTS: [D5(1)150] and [D5(½)100] were the group closest to the control group in terms of both sodium (P = .937; P = .699, respectively) and effective osmolality (P = 1, P = .818, respectively). CONCLUSION: Our results showed that 0.9% NaCl and 0.45% NaCl solutions might be the safest and the most appropriate fluids to maintain normal plasma osmolality in medical situations requiring fluid therapy with high or maintenance rates, respectively.
Subject(s)
Drug Monitoring/methods , Fluid Therapy/methods , Administration, Intravenous , Child , Fluid Therapy/adverse effects , Glucose/administration & dosage , Guidelines as Topic , Humans , Hypotonic Solutions/administration & dosage , Sodium Chloride/administration & dosage , Water-Electrolyte Imbalance/therapyABSTRACT
Hospital-acquired acute hyponatremia is increasingly recognized as a cause of morbidity and mortality in children. It has been attributed primarily to the use of hypotonic intravenous (IV) fluids to maintain fluid and electrolyte requirements. This practice point outlines current understanding of the problem and summarizes recent research dealing with this issue. Detailed recommendations are made for the prescription of IV maintenance fluids in children between one month and 18 years of age. The use of isotonic fluid (D5W.0.9% NaCl) is recommended in most circumstances. Hypotonic IV fluids containing less than 0.45% NaCl should not be used to provide routine IV fluid maintenance requirements.
L'hyponatrémie aiguë d'origine nosocomiale est de plus en plus reconnue comme une cause de morbidité et de mortalité chez les enfants. Elle est surtout attribuée à l'utilisation de solutés intraveineux (IV) hypotoniques pour respecter les besoins liquidiens et électrolytiques. Le présent point de pratique expose les connaissances actuelles du problème et contient un résumé des recherches récentes sur le sujet. Il contient également des recommandations détaillées sur la prescription de soluté IV d'entretien chez les enfants de un mois à 18 ans. On recommande d'utiliser des liquides isotoniques (D5W et NaCl à 0,9 %) dans la plupart des cas. Il faut éviter les solutés IV hypotoniques qui contiennent moins de 0,45 % de NaCl pour administrer les solutés IV d'entretien habituels.