Acute Hyponatremia Related to Intravenous Fluid Administration in Hospitalized Children: An Observational Study

Abstract

Objective. To develop hyponatremia (plasma sodium concentration [P_Na] Methods. All children who presented to the emergency department in a 3-month period and had at least 1 P_Na measured (n = 1586) were evaluated. Those who were admitted were followed for the next 48 hours to identify patients with hospital-acquired hyponatremia. An age- and gender-matched case-control (1:3) analysis was performed with patients who did not become hyponatremic. Results. Hyponatremia (P_Na Na measurements. Although 96 patients were hyponatremic on presentation, our study group consisted of 40 patients who developed hyponatremia in hospital. The case-control study showed that the patients in the hospital-acquired hyponatremia group received significantly more EFW and had a higher positive water balance. With respect to outcomes, 2 patients had major neurologic sequelae and 1 died. Conclusion. The most important factor for hospital-acquired hyponatremia is the administration of hypotonic fluid. We suggest that hypotonic fluid not be given to children when they have a P_Na <138 mmol/L.