Use of hypotonic fluids in the prescription of maintenance intravenous fluid therapy

Peris, J.M. Rius; Rivas-Juesas, Cristina; Pérez, Ana Isabel Maraña; Pérez, Roi Piñeiro; Alapont, Vicente Modesto i; Mallea, Javier Miranda; León, Abel Cuéllar de

doi:10.1016/j.anpede.2018.10.010

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…Our results are consistent with both a recent study conducted in Spain which reveals that 29% of all paediatricians there continue to use hypotonic fluids as maintenance intravenous fluid [33]; as well as a study conducted in the USA showing that the majority of paediatricians choose to use hypotonic maintenance intravenous fluid in daily practice [34]. Considering that intravenous fluids are one of the most commonly prescribed therapies [35], our results on prescribing practices in children and patients with potentially increased intracranial pressure support further risk minimisation measures.…”

Section: Use Of Hypotonic Intravenous Fluidssupporting

confidence: 93%

Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices

Sindahl

Overgaard-Steensen

Kildemoes

et al. 2020

JCM

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Background: Hyponatraemia is associated with increased morbidity, increased mortality and is frequently hospital-acquired due to inappropriate administration of hypotonic fluids. Despite several attempts to minimise the risk, knowledge is lacking as to whether inappropriate prescribing practice continues to be a concern. Methods: A cross-sectional survey was performed in Danish emergency department physicians in spring 2019. Prescribing practices were assessed by means of four clinical scenarios commonly encountered in the emergency department. Thirteen multiple-choice questions were used to measure knowledge. Results: 201 physicians responded corresponding to 55.4% of the total population of physicians working at emergency departments in Denmark. About a quarter reported that they would use hypotonic fluids in patients with increased intracranial pressure and 29.4% would use hypotonic maintenance fluids in children, both of which are against guideline recommendations. Also, 29.4% selected the correct fluid, a 3% hypertonic saline solution, for a patient with hyponatraemia and severe neurological symptoms, which is a medical emergency. Most physicians were unaware of the impact of hypotonic fluids on plasma sodium in acutely ill patients. Conclusion: Inappropriate prescribing practices and limited knowledge of a large number of physicians calls for further interventions to minimise the risk of hospital-acquired hyponatraemia.

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Section: Use Of Hypotonic Intravenous Fluidssupporting

confidence: 93%

Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices

Sindahl

Overgaard-Steensen

Kildemoes

et al. 2020

JCM

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Incidence and Severity of Community- and Hospital-Acquired Hyponatremia in Pediatrics

Rius-Peris

Tambe

Sáez

et al. 2022

JCM

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Hyponatremia is the most common electrolyte disturbance in hospitalized children, with a reported incidence of 15–30%, but its overall incidence and severity are not well known. The objective of our study was to determine the incidence, severity, and associated risk factors of community- and hospital-acquired hyponatremia on a general pediatric ward. Data of 5550 children admitted from June 2012 to December 2019 on plasma sodium and discharge diagnosis were analyzed by logistic regression model. Clinically relevant diagnostic groups were created. Hyponatremia was classified as mild, moderate, and severe. The incidence of community- and hospital-acquired hyponatremia was 15.8% and 1.4%, respectively. Most of the cases were mild (90.8%) to moderate (8.6%), with only two cases of severe community-acquired hyponatremia. There were no clinical complications in any of the hyponatremic children. Age and diagnosis at discharge were principal factors significantly correlated with hyponatremia. Community-acquired hyponatremia is more common than hospital-acquired hyponatremia in clinical practice. Severe cases of both types are rare. Children from 2 to 11 years of age presenting with infections, cardiovascular disorders, and gastrointestinal disorders are at risk of developing hyponatremia.

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Use of hypotonic fluids in the prescription of maintenance intravenous fluid therapy

Cited by 2 publications

References 22 publications

Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices

Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices

Incidence and Severity of Community- and Hospital-Acquired Hyponatremia in Pediatrics

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