The effect of NaCl 0.9% and NaCl 0.45% on sodium,chloride,and acid-base balance in a PICU population

Objectives to study the effect of two intravenous maintenance fluids on plasma sodium (na),and acid-base balance in pediatric intensive care patients during the first 24 h of hospitalization. methods a prospective randomized controlled study was performed,which allocated 233 patients to groups: (a) nacl 0.9% or (b) nacl 0.45%. patients were aged 1 day to 18 years,had normal electrolyte concentrations,and suffered an acute insult (medical/surgical). main outcome measured: change in plasma sodium. parametric tests: t-tests,anova,x2 statistical significance level was set at α = 0.05. results group a (n = 130): serum na increased by 2.91 (±3.9) mmol/l at 24 h (p < 0.01); 2% patients had na higher than 150 mmol/l. mean urinary na: 106.6 (±56.8) mmol/l. no change in ph at 0 and 24 h. group b (n = 103): serum na did not display statistically significant changes. fifteen percent of the patients had na < 135 mmol/l at 24 h. the two fluids had different effects on respiratory and post-operative situations. conclusions the use of saline 0.9% was associated with a lower incidence of electrolyte disturbances. © 2015 sociedade brasileira de pediatria.