Risk factors for hyponatremia after hypotonic fluid infusion
Background Hypotonic maintenance i.v. fluids (IVF) pose a higher risk of hyponatremia than isotonic maintenance IVF, but isotonic maintenance IVF can result in excess sodium (Na) load in children. This study analyzed the incidence and risk factors for hyponatremia in children given hypotonic fluids...
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| Veröffentlicht in: | Pediatrics international 2019-12, Vol.61 (12), p.1239-1243 |
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| creator | Shirai, Yoko Miura, Kenichiro Shimizu, Satoru Hattori, Motoshi Shimizu, Norikazu |
| description | Background
Hypotonic maintenance i.v. fluids (IVF) pose a higher risk of hyponatremia than isotonic maintenance IVF, but isotonic maintenance IVF can result in excess sodium (Na) load in children. This study analyzed the incidence and risk factors for hyponatremia in children given hypotonic fluids with different Na concentrations and different maintenance rates.
Methods
We performed a retrospective analysis using medical charts of children aged 3 months–15 years. The children were normonatremic (Na ≥135 mmol/L and |
| doi_str_mv | 10.1111/ped.14000 |
| format | Article |
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Hypotonic maintenance i.v. fluids (IVF) pose a higher risk of hyponatremia than isotonic maintenance IVF, but isotonic maintenance IVF can result in excess sodium (Na) load in children. This study analyzed the incidence and risk factors for hyponatremia in children given hypotonic fluids with different Na concentrations and different maintenance rates.
Methods
We performed a retrospective analysis using medical charts of children aged 3 months–15 years. The children were normonatremic (Na ≥135 mmol/L and <145 mmol/L) before IVF, and given IVF containing 35 mmol/L Na at a 100% maintenance rate (Na 35) or fluids containing 84 mmol/L Na at a 70% maintenance rate (Na 84) for 24–48 h.
Results
Of a total of 463 children, hyponatremia (Na <135 mmol/L) occurred in 46/275 children (17%) given Na 35, and 16/188 (9%) given Na 84 (P = 0.01). On multivariate logistic regression analysis, Na 35 (OR, 2.19; 95%CI: 1.04–4.62), low clinical dehydration scale (CDS) score before IVF (OR, 0.17; 95%CI: 0.06‐0.49), and high body temperature 24–48 h after maintenance IVF (OR, 2.39; 95%CI: 1.79–3.18) were independent risk factors for hyponatremia.
Conclusions
Maintenance IVF with low Na concentration at a 100% maintenance rate, low CDS before IVF, and a high body temperature 24–48 h after maintenance IVF are independent risk factors for hyponatremia.</description><identifier>ISSN: 1328-8067</identifier><identifier>EISSN: 1442-200X</identifier><identifier>DOI: 10.1111/ped.14000</identifier><identifier>PMID: 31469462</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Body temperature ; Children ; Dehydration ; Hyponatremia ; hypotonic fluid ; maintenance i.v. fluid ; maintenance rate ; Pediatrics ; Regression analysis ; Risk factors ; Sodium</subject><ispartof>Pediatrics international, 2019-12, Vol.61 (12), p.1239-1243</ispartof><rights>2019 Japan Pediatric Society</rights><rights>2019 Japan Pediatric Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3370-5dfef2891880d9fa65b97b8fb7aaadd211874a88b2a35b8cda7326dd316e495a3</cites><orcidid>0000-0002-7457-7924 ; 0000-0002-4309-8672 ; 0000-0003-3734-4766 ; 0000-0002-9483-8482</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fped.14000$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fped.14000$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31469462$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shirai, Yoko</creatorcontrib><creatorcontrib>Miura, Kenichiro</creatorcontrib><creatorcontrib>Shimizu, Satoru</creatorcontrib><creatorcontrib>Hattori, Motoshi</creatorcontrib><creatorcontrib>Shimizu, Norikazu</creatorcontrib><title>Risk factors for hyponatremia after hypotonic fluid infusion</title><title>Pediatrics international</title><addtitle>Pediatr Int</addtitle><description>Background
Hypotonic maintenance i.v. fluids (IVF) pose a higher risk of hyponatremia than isotonic maintenance IVF, but isotonic maintenance IVF can result in excess sodium (Na) load in children. This study analyzed the incidence and risk factors for hyponatremia in children given hypotonic fluids with different Na concentrations and different maintenance rates.
Methods
We performed a retrospective analysis using medical charts of children aged 3 months–15 years. The children were normonatremic (Na ≥135 mmol/L and <145 mmol/L) before IVF, and given IVF containing 35 mmol/L Na at a 100% maintenance rate (Na 35) or fluids containing 84 mmol/L Na at a 70% maintenance rate (Na 84) for 24–48 h.
Results
Of a total of 463 children, hyponatremia (Na <135 mmol/L) occurred in 46/275 children (17%) given Na 35, and 16/188 (9%) given Na 84 (P = 0.01). On multivariate logistic regression analysis, Na 35 (OR, 2.19; 95%CI: 1.04–4.62), low clinical dehydration scale (CDS) score before IVF (OR, 0.17; 95%CI: 0.06‐0.49), and high body temperature 24–48 h after maintenance IVF (OR, 2.39; 95%CI: 1.79–3.18) were independent risk factors for hyponatremia.
Conclusions
Maintenance IVF with low Na concentration at a 100% maintenance rate, low CDS before IVF, and a high body temperature 24–48 h after maintenance IVF are independent risk factors for hyponatremia.</description><subject>Body temperature</subject><subject>Children</subject><subject>Dehydration</subject><subject>Hyponatremia</subject><subject>hypotonic fluid</subject><subject>maintenance i.v. fluid</subject><subject>maintenance rate</subject><subject>Pediatrics</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Sodium</subject><issn>1328-8067</issn><issn>1442-200X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp10E1LwzAYB_AgipvTg19ACl700C1vbVLwInO-wEARBW8hbRLM7JqatMi-vdFuF8FcnvDw48_DH4BTBKcovlmr1RRRCOEeGCNKcYohfNuPf4J5ymHORuAohFUEnHF6CEYE0bygOR6Dq2cbPhIjq875kBjnk_dN6xrZeb22MpGm08Oqc42tElP3ViW2MX2wrjkGB0bWQZ9s5wS83i5e5vfp8vHuYX69TCtCGEwzZbTBvECcQ1UYmWdlwUpuSialVAojxBmVnJdYkqzklZKM4FwpgnJNi0ySCbgYclvvPnsdOrG2odJ1LRvt-iAw5gQhyhGJ9PwPXbneN_E6gQkucpoVBYvqclCVdyF4bUTr7Vr6jUBQ_FQqYqXit9Joz7aJfbmO253cdRjBbABfttab_5PE0-JmiPwGyJF_KA</recordid><startdate>201912</startdate><enddate>201912</enddate><creator>Shirai, Yoko</creator><creator>Miura, Kenichiro</creator><creator>Shimizu, Satoru</creator><creator>Hattori, Motoshi</creator><creator>Shimizu, Norikazu</creator><general>Blackwell Publishing Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7457-7924</orcidid><orcidid>https://orcid.org/0000-0002-4309-8672</orcidid><orcidid>https://orcid.org/0000-0003-3734-4766</orcidid><orcidid>https://orcid.org/0000-0002-9483-8482</orcidid></search><sort><creationdate>201912</creationdate><title>Risk factors for hyponatremia after hypotonic fluid infusion</title><author>Shirai, Yoko ; Miura, Kenichiro ; Shimizu, Satoru ; Hattori, Motoshi ; Shimizu, Norikazu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3370-5dfef2891880d9fa65b97b8fb7aaadd211874a88b2a35b8cda7326dd316e495a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Body temperature</topic><topic>Children</topic><topic>Dehydration</topic><topic>Hyponatremia</topic><topic>hypotonic fluid</topic><topic>maintenance i.v. fluid</topic><topic>maintenance rate</topic><topic>Pediatrics</topic><topic>Regression analysis</topic><topic>Risk factors</topic><topic>Sodium</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shirai, Yoko</creatorcontrib><creatorcontrib>Miura, Kenichiro</creatorcontrib><creatorcontrib>Shimizu, Satoru</creatorcontrib><creatorcontrib>Hattori, Motoshi</creatorcontrib><creatorcontrib>Shimizu, Norikazu</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shirai, Yoko</au><au>Miura, Kenichiro</au><au>Shimizu, Satoru</au><au>Hattori, Motoshi</au><au>Shimizu, Norikazu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for hyponatremia after hypotonic fluid infusion</atitle><jtitle>Pediatrics international</jtitle><addtitle>Pediatr Int</addtitle><date>2019-12</date><risdate>2019</risdate><volume>61</volume><issue>12</issue><spage>1239</spage><epage>1243</epage><pages>1239-1243</pages><issn>1328-8067</issn><eissn>1442-200X</eissn><abstract>Background
Hypotonic maintenance i.v. fluids (IVF) pose a higher risk of hyponatremia than isotonic maintenance IVF, but isotonic maintenance IVF can result in excess sodium (Na) load in children. This study analyzed the incidence and risk factors for hyponatremia in children given hypotonic fluids with different Na concentrations and different maintenance rates.
Methods
We performed a retrospective analysis using medical charts of children aged 3 months–15 years. The children were normonatremic (Na ≥135 mmol/L and <145 mmol/L) before IVF, and given IVF containing 35 mmol/L Na at a 100% maintenance rate (Na 35) or fluids containing 84 mmol/L Na at a 70% maintenance rate (Na 84) for 24–48 h.
Results
Of a total of 463 children, hyponatremia (Na <135 mmol/L) occurred in 46/275 children (17%) given Na 35, and 16/188 (9%) given Na 84 (P = 0.01). On multivariate logistic regression analysis, Na 35 (OR, 2.19; 95%CI: 1.04–4.62), low clinical dehydration scale (CDS) score before IVF (OR, 0.17; 95%CI: 0.06‐0.49), and high body temperature 24–48 h after maintenance IVF (OR, 2.39; 95%CI: 1.79–3.18) were independent risk factors for hyponatremia.
Conclusions
Maintenance IVF with low Na concentration at a 100% maintenance rate, low CDS before IVF, and a high body temperature 24–48 h after maintenance IVF are independent risk factors for hyponatremia.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>31469462</pmid><doi>10.1111/ped.14000</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-7457-7924</orcidid><orcidid>https://orcid.org/0000-0002-4309-8672</orcidid><orcidid>https://orcid.org/0000-0003-3734-4766</orcidid><orcidid>https://orcid.org/0000-0002-9483-8482</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Body temperature Children Dehydration Hyponatremia hypotonic fluid maintenance i.v. fluid maintenance rate Pediatrics Regression analysis Risk factors Sodium |
| title | Risk factors for hyponatremia after hypotonic fluid infusion |
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