Hypotonic maintenance i.v. fluids are not appropriate in acutely ill patients. Conclusions can't be extrapolated from healthy volunteers

Effect of isotonic vs hypotonic maintenance fluid therapy on urine output, fluid balance, and electrolyte homeostasis: a crossover study in fasting adult volunteers. Reply from the authors

“…K. Malinowski 1, *, B. De France 2 , D. Sun 3 , J. C. A. Carvalho 1 and N. Shehata 1 1 Toronto, Ontario, Canada, 2 Hamilton, Ontario, Canada and 3 London, Ontario, Canada *E-mail: amalinowski@mtsinai.on.ca Editor-Immune thrombocytopenia (ITP) is an autoimmune condition affecting 1-10 in 10 000 pregnancies. 1 The bleeding risk associated with significant thrombocytopenia poses a challenge peripartum, particularly for placement of neuraxial anaesthesia, where evidence to guide practice remains scant.…”

“…1 The bleeding risk associated with significant thrombocytopenia poses a challenge peripartum, particularly for placement of neuraxial anaesthesia, where evidence to guide practice remains scant. 2 Our aim is to describe our experience with neuraxial anaesthesia in the setting of ITP in pregnancy at two tertiary-level academic institutions. The report is a secondary analysis of a retrospective study of pregnant women with ITP at two tertiary-level Canadian academic institutions: Mount Sinai Hospital (MSH), Toronto and McMaster University Medical Centre, Hamilton (MUMC) from January 2000 to August 2014.…”