Key result
Isotonic intravenous maintenance fluid significantly lowered the risk of hyponatremia compared to hypotonic fluid in hospitalized children (OR 0.36; 95% CI 0.26-0.51).
Why the study?
Does isotonic intravenous maintenance fluid reduce the risk of hyponatremia compared to hypotonic fluid in hospitalized pediatric patients?
Meta-Analysis (n=752)
Does isotonic intravenous maintenance fluid reduce the risk of hyponatremia compared to hypotonic fluid in hospitalized pediatric patients?
Odds Ratio: 0.36 (95% CI 0.26–0.51)
Isotonic intravenous maintenance fluid significantly reduces the risk of hyponatremia without increasing hypernatremia risk in hospitalized children compared to hypotonic fluid.
Supports isotonic maintenance fluids as standard in hospitalized children; reinforces Level 1 evidence for guideline updates.
AIM: This study aimed to analyze the effect of isotonic versus hypotonic solution as intravenous maintenance fluid on level of plasma sodium in hospitalized children. METHODS: A fully recursive literature search in May 2013 was conducted in PubMed and EMBASE to identify potentially relevant randomized controlled trials. Jadad score and allocation concealment were adopted to evaluate the methodological quality of each trial. RevMan5.2 was used for statistical analysis. RESULTS: Eight randomized controlled trials with 752 patients were included. Combined analysis showed a significant lower risk of hyponatremia with isotonic solution (odds ratio, 0.36; 95% confidence interval, 0.26-0.51). The isotonic intravenous maintenance did not increase the possibility of hypernatremia (odds ratio, 0.86; 95% confidence interval, 0.36-2.06). CONCLUSIONS: The meta-analysis revealed that there was potential risk of hyponatremia for routine infusion of hypotonic maintenance fluid. The use of isotonic solution was warranted in hospitalized pediatric patients.
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Yang et al. (2015) conducted a meta-analysis in hospitalized children (n=752). Isotonic intravenous maintenance fluid vs. Hypotonic intravenous maintenance fluid was evaluated on hyponatremia (OR 0.36, 95% CI 0.26-0.51). Isotonic intravenous maintenance fluid significantly lowered the risk of hyponatremia compared to hypotonic fluid in hospitalized children (OR 0.36; 95% CI 0.26-0.51).
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