{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T21:30:48Z","timestamp":1764019848326,"version":"3.37.3"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,2,26]],"date-time":"2013-02-26T00:00:00Z","timestamp":1361836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000241","name":"The Physicians' Services Incorporated Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000241","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The study aims to assess the risk of developing hyponatraemia when large\u2010volume bolus fluid rehydration therapy is administered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a prospective randomised study in a tertiary\u2010care centre emergency department. Participants included children with gastroenteritis and dehydration requiring intravenous rehydration. They were randomised to receive 60\u2009<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>\/kg (large) or 20\u2009<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>\/kg (standard) 0.9% saline bolus followed by maintenance 0.9% saline for 3\u2009h. Biochemical tests were performed at baseline and 4\u2009h. The primary outcome measure was the development of hyponatraemia at 4\u2009h. Secondary outcome measures were (i) change in sodium relative to baseline value; (ii) magnitude of decrease among those who experienced a decrease; (iii) risk of hypernatraemia; (iv) correlations between urine parameters and hyponatraemia; and (v) fluid overload.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010four of 224 (38%) participants were hyponatraemic at baseline. At 4\u2009h, 22% (48\/217) had a dysnatraemia, and similar numbers of children were hyponatraemic in both groups: large (23% (26\/112)) versus standard (21% (22\/105)) (<jats:italic>P<\/jats:italic> = 0.69). Among initially hyponatraemic children, 63% (30\/48) who received large\u2010volume rehydration and 44% (15\/34) of those administered standard rehydration were isonatraemic at 4\u2009h (<jats:italic>P<\/jats:italic> = 0.10). Overall, children who received 60\u2009<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>\/kg experienced a larger mean increase (1.6 \u00b1 2.4\u2009<jats:styled-content style=\"fixed-case\">mEq<\/jats:styled-content>\/L vs. 0.9 \u00b1 2.2\u2009<jats:styled-content style=\"fixed-case\">mEq<\/jats:styled-content>\/L; <jats:italic>P<\/jats:italic> = 0.04) and were less likely to experience a sodium decrease of \u22652\u2009<jats:styled-content style=\"fixed-case\">mEq<\/jats:styled-content>\/L (8\/112 vs. 17\/105; <jats:italic>P<\/jats:italic> = 0.04) than those administered 20\u2009<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>\/kg.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Large\u2010volume bolus rehydration therapy with 0.9% saline is safe. It does not promote the development of hyponatraemia over the short term, but hastens the resolution of baseline hyponatraemia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.12120","type":"journal-article","created":{"date-parts":[[2013,2,26]],"date-time":"2013-02-26T12:09:46Z","timestamp":1361880586000},"page":"215-222","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Bolus fluid therapy and sodium homeostasis in paediatric gastroenteritis"],"prefix":"10.1111","volume":"49","author":[{"given":"Stephen B","family":"Freedman","sequence":"first","affiliation":[{"name":"Sections of Emergency Medicine and Gastroenterology Department of Paediatrics Children's Hospital and Alberta Children's Hospital Research Institute University of Calgary  Alberta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis F","family":"Geary","sequence":"additional","affiliation":[{"name":"Nephrology The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Child Health Evaluative Sciences Hospital for Sick Children Research Institute The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Paediatrics Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,2,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2005.084103"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.2.227"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-009-1428-y"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-2376"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.5.1279"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7289.780"},{"key":"e_1_2_9_8_1","first-page":"971","volume-title":"Tintinalli's Emergency Medicine: A Comprehensive Study Guide","author":"Nager AL","year":"2010"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.22.2746"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.05.035"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-3141"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2010.00767.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922809336670"},{"issue":"16","key":"e_1_2_9_14_1","first-page":"1","article-title":"Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy","volume":"52","author":"King CK","year":"2003","journal-title":"MMWR Recomm. Rep."},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d6976"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e3283440fd9"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.19.5.823"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2005.00092.x"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005253422107"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005183422006"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-010-1505-2"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d7083"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.pec.0000121239.99242.49"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1197\/j.aem.2006.10.098"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2008.09.046"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-2985"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjpc.12120","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjpc.12120","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.12120","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,15]],"date-time":"2023-10-15T04:28:39Z","timestamp":1697344119000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.12120"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,2,26]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,3]]}},"alternative-id":["10.1111\/jpc.12120"],"URL":"https:\/\/doi.org\/10.1111\/jpc.12120","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"type":"print","value":"1034-4810"},{"type":"electronic","value":"1440-1754"}],"subject":[],"published":{"date-parts":[[2013,2,26]]},"assertion":[{"value":"2012-02-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-02-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}