Change In Clinical And Biochemical Parameters After Using 0.9% Normal Saline As Maintenance Intravenous Fluid In Non-critically Ill Children-An Experience from A Tertiary Care Hospital.

The recent recommendations are to use isotonic fluids as maintenance intravenous fluids (mIVF) in children and most commonly prescribed fluid is 0.9%NS(Normal Saline) but there are concerns of hypernatremia, fluid overload and hyperchloremic metabolic acidosis leading to increased morbidity and even mortality mainly by its adverse effects on kidneys. Most of available literature is in adult population. There is still not enough evidence to approve or disapprove 0.9% NS as safe mIVF in children. This study was done to assess the clinical and biochemical effects of 0.9% Sodium chloride as isotonic mIVF in general pediatric non-critically ill patients.

Descriptive cohort study in admitted children requiring mIVF for minimum 24 hours. Change in blood pressure(BP) and biochemical parameters like serum sodium(S Na), serum chloride(S Cl) and bicarbonate and to observe incidence of hypo/hypernatremia, hyperchloremia and metabolic acidosis at 24 and 48 hours from baseline.

Out of 250 children analyzed, mean age was 3.79±3.2 years with majority (43.6%) in the age group of 2 months- 1years. There was no significant change in BP at any time point. Mean serum chloride level at baseline, 24hours and 48hours to be 103.81±4.717,104.5±4.581 and 105.28±4.545 respectively with a significant rise at 48 hours of mIVF(p-value< 0.001) and among 3 points of time(p-value<0.01]. There was significant decrease in bicarbonate level at 48 hours from baseline(p<0.05).

0.9% NS as mIVF in non-critically ill paediatric patients leads to significant increase in serum chloride levels leading to hyperchloremia and metabolic acidosis.