M Denis1,2,3,4, A Di Giacomo5, E Lacotte5,6,7, F Porcheret5,8, N Letouzé5, B Lauzier9, I Goyer10, D Brossier5,11. 1. Pediatric Intensive Care Unit, CHU de Caen, 14000, Caen, France. manon.denis@chu-nantes.fr. 2. Pediatric Intensive Care Unit, CHU de Nantes, 44000, Nantes, France. manon.denis@chu-nantes.fr. 3. CNRS, INSERM, l'institut du thorax, Université de Nantes, CHU Nantes, 44000, Nantes, France. manon.denis@chu-nantes.fr. 4. Service de reanimation pédiatrique, CHU de Nantes, 4ème étage bâtiment HME, 38 boulevard Jean-Monnet, 44093, Nantes Cedex 1, France. manon.denis@chu-nantes.fr. 5. Pediatric Intensive Care Unit, CHU de Caen, 14000, Caen, France. 6. Pediatric Department, CHU de Rouen, 76000, Rouen, France. 7. Medical School, Université de Rouen, 76000, Rouen, France. 8. Pediatric Nephrology, CHU de Nantes, 44000, Nantes, France. 9. Institut du thorax, INSERM, CNRS, UNIV Nantes, 44000, Nantes, France. 10. Department of Pharmacy, CHU de Caen, 14000, Caen, France. 11. Medical School, Université Caen Normandie, 14000, Caen, France.
Abstract
BACKGROUND: The principles for maintenance intravenous fluid prescription in children were developed in the 1950s. These guidelines based on the use of hypotonic solutions have been challenged regularly for they seem to be associated with an increased risk of hospital-acquired hyponatremia. CASE PRESENTATION: We report the case of a 4-week-old Caucasian child admitted for acute bronchiolitis who received hypotonic maintenance fluids and developed severe hyponatremia (94 mmol/L) with hyponatremic encephalopathy. CONCLUSION: This clinical situation can serve as a reminder of the latest recommendations from the American Academy of Pediatrics regarding the use of intravenous fluids that promote the use of isotonic fluids in children.
BACKGROUND: The principles for maintenance intravenous fluid prescription in children were developed in the 1950s. These guidelines based on the use of hypotonic solutions have been challenged regularly for they seem to be associated with an increased risk of hospital-acquired hyponatremia. CASE PRESENTATION: We report the case of a 4-week-old Caucasian child admitted for acute bronchiolitis who received hypotonic maintenance fluids and developed severe hyponatremia (94 mmol/L) with hyponatremic encephalopathy. CONCLUSION: This clinical situation can serve as a reminder of the latest recommendations from the American Academy of Pediatrics regarding the use of intravenous fluids that promote the use of isotonic fluids in children.
Authors: Christine Koczmara; Andrew W Wade; Peter Skippen; Mary Jane Campigotto; Kim Streitenberger; Roxane Carr; Elaine Wong; Karen Robertson Journal: Dynamics Date: 2010