Department of Paediatrics, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
Paediatr Int Child Health. 2020 Feb;40(1):44-49. doi: 10.1080/20469047.2019.1619059. Epub 2019 May 29.
: To prevent the risk of iatrogenic hyponatraemia in hospitalised children, isotonic fluid has been recommended as maintenance intravenous fluid (IVF). There are few studies which compare half normal saline with normal saline as maintenance IVF in general paediatric wards.: To compare the safety and efficacy of half normal saline with normal saline as maintenance IVF in general paediatric wards.: Children aged between 3 months and 5 years with an anticipated requirement for IVF for 24 h were randomised to receive either half normal saline (0.45% saline in 5% dextrose) or normal saline (0.9% saline in 5% dextrose). The primary objective was to compare the incidence of hyponatraemia (serum sodium <135 mmol/L with a decrease from baseline of at least 4 mmol/L) at 24 h in children receiving half normal saline with those receiving normal saline. Secondary objectives were to compare the incidence of moderate (sodium <130 mmol/L), severe (sodium <125 mmol/L) and symptomatic hyponatraemia, change in serum sodium level from baseline and the incidence of hypernatraemia.: A total of 168 children were randomised to receive either normal saline ( = 84) or half normal saline ( = 84). More than two-thirds of the children were suffering from respiratory diseases (pneumonia and bronchiolitis) and diseases of the nervous system (meningoencephalitis, febrile seizures and epilepsy). The incidence of hyponatraemia at 12 h in children receiving half normal saline was similar to that in those receiving normal saline (6 4.8%; Relative risk (RR) 1.2; 95% CI 0.3.0-4.8; = 0.73). Although the incidence of hyponatraemia at 24 h in children receiving half normal saline was higher than in those receiving normal saline, the difference was not statistically significant (14.3 6%; RR 2.6; 95% CI 0.9-7.8; = 0.07). One child in the isotonic group and one in the hypotonic group developed moderate and severe hyponatraemia, respectively. There was no significant difference in the incidence of hypernatraemia between two groups (RR 0.7; 95% CI 0.16-3.3).: Half-normal saline as maintenance IVF does not result in a significantly increased risk of hyponatraemia in general paediatric ward patients under 5 years of age.
在住院的儿童中，为了预防医源性低钠血症的风险，已推荐使用等渗液作为维持性静脉输液（IVF）。很少有研究比较半生理盐水与生理盐水作为普通儿科病房的维持性 IVF。
比较半生理盐水与生理盐水作为普通儿科病房维持性 IVF 的安全性和疗效。
将年龄在 3 个月至 5 岁之间、预计需要 24 小时 IVF 的儿童随机分为半生理盐水（5%葡萄糖中的 0.45%盐水）或生理盐水（5%葡萄糖中的 0.9%盐水）组。主要目的是比较接受半生理盐水治疗的儿童与接受生理盐水治疗的儿童在 24 小时时低钠血症（血清钠 <135mmol/L，与基线相比至少下降 4mmol/L）的发生率。次要目标是比较中度（血清钠 <130mmol/L）、重度（血清钠 <125mmol/L）和有症状性低钠血症的发生率、血清钠水平从基线的变化以及高钠血症的发生率。
共 168 名儿童被随机分为生理盐水组（n=84）或半生理盐水组（n=84）。超过三分之二的儿童患有呼吸系统疾病（肺炎和细支气管炎）和神经系统疾病（脑膜炎、热性惊厥和癫痫）。接受半生理盐水治疗的儿童在 12 小时时低钠血症的发生率与接受生理盐水治疗的儿童相似（6 4.8%；相对风险（RR）1.2；95%CI 0.3-4.8； = 0.73）。尽管接受半生理盐水治疗的儿童在 24 小时时低钠血症的发生率高于接受生理盐水治疗的儿童，但差异无统计学意义（14.3 6%；RR 2.6；95%CI 0.9-7.8； = 0.07）。等渗组和低渗组各有 1 例儿童出现中度和重度低钠血症。两组高钠血症的发生率无显著差异（RR 0.7；95%CI 0.16-3.3）。
在 5 岁以下普通儿科病房患者中，半生理盐水作为维持性 IVF 不会显著增加低钠血症的风险。
