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Pediatría (Asunción)

On-line version ISSN 1683-9803


IRAMAIN, Ricardo. Parenteral Hydration in Children, is the Paradigm Shifting ?. Pediatr. (Asunción) [online]. 2014, vol.41, n.2, pp.143-149. ISSN 1683-9803.

Maintenance intravenous (IV) fluids are designed to maintain homeostasis in patients unable to ingest required water, electrolytes, and calories. The traditional criteria for determining fluid volume and composition date from a 1957 article by Holliday and Segar that describes the relationships between weight, energy consumption, physiologic loss, and healthy children  Their estimates of daily electrolyte requirements support the use of the hypotonic solutions that were once much used in pediatric cases. However, in hospitalized patients who may have physiologic disorders, reduced caloric requirements and urine output, and high levels of antidiuretic hormone, the use of hypotonic fluids is not ideal. Various studies over the last two decades have demonstrated that hypotonic solutions may cause increased incidence of hyponatremia. This dyselectrolytemia can be very harmful and cause severe pathologies ranging from neurological disorders to death.  This review provides evidence supporting the use of isotonic rather than hypotonic fluids for maintenance intravenous therapy.

Keywords : Fluid therapy; maintenance therapy; hypotonic solutions; hyponatremia.

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