The Clinical and Metabolic Derangements after Using 0.9% Normal Saline as Maintenance Intravenous Fluid in Children

Background: Isotonic fluids like 0.9% normal saline (NS) are recommended for maintenance intravenous fluid (mIVF) therapy in children. However, concerns exist regarding hyperchloremia and its associated complications, particularly in younger children. Objective: The objective of the study was to evaluate the clinical and metabolic effects of 0.9% NS as mIVF in noncritically ill pediatric patients. Materials and Methods: This longitudinal study included 80 children aged 1 month to 13 years admitted to a tertiary care center, who received 0.9% NS as mIVF for at least 50% of a 24-h period. Baseline and 48-h clinical and biochemical parameters were recorded and compared. Results: After 48 h, there was a significant decrease in heart rate, respiratory rate, blood urea, and serum creatinine, and a significant increase in blood pressure, serum sodium, potassium, and chloride ( P < 0.05). Hyperchloremia was observed in 7.5% of children, all aged <5 years. Conclusion: 0.9% NS may lead to significant clinical and metabolic changes, particularly hyperchloremia in younger children.