COMPARISON OF SODIUM ABNORMALITIES ASSOCIATED WITH HYPOTONIC VERSUS ISOTONIC MAINTENANCE INFUSIONS IN HOSPITALIZED CHILDREN

Abstract

OBJECTIVE:                     To compare Sodium abnormalities associated with Maintenance Infusions, Hypotonic versus isotonic in hospitalized children: A Randomized Controlled Trial MATERIAL AND METHODS: This study was a randomized control trial conducted in the Department of Pediatrics A Hayat Abad Medical Complex Peshawar from 28 October 2020 to 28 April 2021. All the admitted patients aged 1 year to 12 years requiring maintenance infusion and were nothing by mouth (NBM) for at least 48 hours and serum sodium between 135-145 mmol/l were included in the study. Patients with renal disease and on drugs affecting sodium level were excluded from the study. Two hundred and four patients who fulfilled the inclusion criteria, were randomly classified into two groups A and B 102 each. Group A was given Isotonic fluids (0.9% Sodium Chloride and 5% Dextrose water with Potassium 20 mmol/L) and Group B was given hypotonic fluids (0.45% Sodium Chloride and 5% Dextrose water with Potassium 20 mmol/L). The baseline tests and targeted tests, such as CBC, Blood sugar, urea, creatinine, electrolytes (sodium, potassium, and chloride), osmolality, and arterial blood gases, were performed. Data was analyzed using SPSS version 21.0. The post-stratification chi-square test was utilized to examine potential effect modifiers, and results were presented in tables.     RESULTS: For a total of 204, there were 43 (42.3%) female patients and 59 (57.8%) male patients in Group A. Eighty (78.4%) male patients and twenty-two (21.6%) female patients were documented in Group B. In Group A, 61 (59.8%) patients had ages of 1-6 years while 41 patients (40.2%) were 7-12 years old. Eighteen patients in this group developed hyponatremia after receiving isotonic fluids. Fifty-two (51.0%) patients in Group B were 1-6-year-old and 50 (49.0%) patients were 7-12 years old. while 49 patients in this group developed, hyponatremia receiving hypotonic fluids. Patients given isotonic fluids didn’t develop any complications (Hypernatremia and hyperchloremic metabolic acidosis).   CONCLUSION: On the basis of the results of this study, Isotonic intravenous maintenance fluids are a safe option in the pediatric population.   KEYWORDS: Children, Intravenous fluids, Hypotonic, Isotonic Maintenance Infusions