Maintenance intravenous fluid therapy in infants with sepsis and hyponatremia: a clinical trial

• Published in: BMC pediatrics Vol. 24; no. 1; pp. 497 - 7
• Main Authors: Milani, Hani, Tajalli, Saleheh, Behrouzi, Kamran, Homan, Nakisa, Zamaniashtiani, Fateme, Vafaee, Ali, Vahedi, Zahra, Khalesi, Nasrin
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 02.08.2024; BioMed Central; BMC
• Subjects: Blood Urea Nitrogen; Care and treatment; Clinical trials; Creatinine - blood; Creatinine - urine; Demographic aspects; Diagnosis; Dosage and administration; Double-Blind Method; Electrolytes; Female; Fluid therapy; Fluid Therapy - methods; Fluids; Gestational age; Hospitalization; Humans; Hypernatremia; Hyponatremia; Hyponatremia - etiology; Hyponatremia - therapy; Infant; Infant, Newborn; Infusions, Intravenous; Intervention; Maintenance fluid; Male; Metabolism; Mortality; Neonate; Newborn; Newborn babies; Pediatrics; Potassium; Potassium - blood; Potassium - urine; Premature babies; Saline Solution - administration & dosage; Saline Solution - therapeutic use; Sepsis; Sepsis - therapy; Sodium; Sodium - blood; Sodium - urine; Testing; Urine; Iran; Hyponatremia; Neonate; Newborn; Sodium; Maintenance fluid
• ISSN: 1471-2431; 1471-2431
• DOI: 10.1186/s12887-024-04901-0

This study aimed to compare the effect of two methods of maintenance intravenous fluid therapy on hyponatremia in hospitalized infants with sepsis. In a double-blinded randomized clinical trial, 60 term infants with sepsis were enrolled. Blood samples were taken to determine sodium, potassium, Creatinine, and BUN levels before the initiation of treatment. Urine samples were taken to assess specific gravity and urinary output. Infants in the intervention group received half saline in 10% dextrose and infants in the control group were assigned to receive the conventional solution as maintenance. The above indicators were re-evaluated 24 and 48 h after the initiation of treatment. Two groups were compared concerning the incidence of hyponatremia, and other criteria such as urinary output and urinary specific gravity, blood urea nitrogen (BUN), and creatinine levels. Hyponatremia was more common in the control group. Sodium levels were significantly higher in half saline recipients 24 h (137.83 ± 2.86 vs. 134.37 ± 1.91 mmol/L), and 48 h (138.10 ± 2.41 vs. 133.66 ± 1.98 mmol/L) after treatment (P < 0.001). Although BUN in the intervention group was significantly higher in comparison to the control group, the difference in urinary output, urine specific gravity, potassium, and Creatinine levels were not significant in the two groups. The use of a half-saline solution as maintenance fluid reduces the risk of hyponatremia after 48 h when compared to 0.18%NaCl. This has been registered at Iranian Registry of Clinical Trials (Retrospectively registered, Registration date: 2017-10-12, identifier: IRCT2017053034223N1, https://irct.behdasht.gov.ir/trial/26204 ).