{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:58:51Z","timestamp":1791593931749,"version":"4.3.4"},"reference-count":67,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12,1]]},"abstract":"<jats:p>Maintenance intravenous fluids (IVFs) are used to provide critical supportive care for children who are acutely ill. IVFs are required if sufficient fluids cannot be provided by using enteral administration for reasons such as gastrointestinal illness, respiratory compromise, neurologic impairment, a perioperative state, or being moribund from an acute or chronic illness. Despite the common use of maintenance IVFs, there is high variability in fluid prescribing practices and a lack of guidelines for fluid composition administration and electrolyte monitoring. The administration of hypotonic IVFs has been the standard in pediatrics. Concerns have been raised that this approach results in a high incidence of hyponatremia and that isotonic IVFs could prevent the development of hyponatremia. Our goal in this guideline is to provide an evidence-based approach for choosing the tonicity of maintenance IVFs in most patients from 28 days to 18 years of age who require maintenance IVFs. This guideline applies to children in surgical (postoperative) and medical acute-care settings, including critical care and the general inpatient ward. Patients with neurosurgical disorders, congenital or acquired cardiac disease, hepatic disease, cancer, renal dysfunction, diabetes insipidus, voluminous watery diarrhea, or severe burns; neonates who are younger than 28 days old or in the NICU; and adolescents older than 18 years old are excluded. We specifically address the tonicity of maintenance IVFs in children.<\/jats:p>\n                  <jats:p>The Key Action Statement of the subcommittee is as follows:<\/jats:p>\n                  <jats:p>1A: The American Academy of Pediatrics recommends that patients 28 days to 18 years of age requiring maintenance IVFs should receive isotonic solutions with appropriate potassium chloride and dextrose because they significantly decrease the risk of developing hyponatremia (evidence quality: A; recommendation strength: strong)<\/jats:p>","DOI":"10.1542\/peds.2018-3083","type":"journal-article","created":{"date-parts":[[2018,11,26]],"date-time":"2018-11-26T08:25:10Z","timestamp":1543220710000},"source":"Crossref","is-referenced-by-count":208,"title":["Clinical Practice Guideline: Maintenance Intravenous Fluids in Children"],"prefix":"10.1542","volume":"142","author":[{"given":"Leonard G.","family":"Feld","sequence":"first","affiliation":[{"name":"Retired, Nicklaus Children's Health System, Miami, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel R.","family":"Neuspiel","sequence":"additional","affiliation":[{"name":"Retired, Levine Children\u2019s Hospital, Charlotte, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byron A.","family":"Foster","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University, Portland, Oregon;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Leu","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Washington and Seattle Children\u2019s Hospital, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"Garber","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine \u2013 Jacksonville, University of Florida, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Austin","sequence":"additional","affiliation":[{"name":"Departments of Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajit K.","family":"Basu","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Children\u2019s Healthcare of Atlanta, Atlanta, Georgia;"},{"name":"Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Edward E.","family":"Conway","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, Jacobi Medical Center, Bronx, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Fehr","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Pediatrics, Washington University in St Louis, St Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Houston Methodist Hospital, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron L.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Echo V.","family":"Rowe","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Stanford University School of Medicine, Stanford, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Waseem","sequence":"additional","affiliation":[{"name":"Lincoln Medical Center, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Moritz","sequence":"additional","affiliation":[{"name":"Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"SUBCOMMITTEE ON FLUID AND ELECTROLYTE THERAPY","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2018,12,1]]},"reference":[{"issue":"6","key":"2021121015170889100_B1","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1111\/j.1365-2923.2008.03009.x","article-title":"Textbook coverage of a common topic: fluid management of patients after surgery.","volume":"42","author":"Chawla","year":"2008","journal-title":"Med Educ"},{"key":"2021121015170889100_B2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1471-2482-8-10","article-title":"Intravenous postoperative fluid prescriptions for children: a survey of practice.","volume":"8","author":"Davies","year":"2008","journal-title":"BMC Surg"},{"issue":"10","key":"2021121015170889100_B3","doi-asserted-by":"crossref","first-page":"e465","DOI":"10.1111\/j.1651-2227.2012.02780.x","article-title":"Maintenance intravenous fluid prescribing practices among paediatric residents.","volume":"101","author":"Freeman","year":"2012","journal-title":"Acta Paediatr"},{"issue":"7","key":"2021121015170889100_B4","doi-asserted-by":"crossref","first-page":"282","DOI":"10.3345\/kjp.2013.56.7.282","article-title":"Intravenous fluid prescription practices among pediatric residents in Korea.","volume":"56","author":"Lee","year":"2013","journal-title":"Korean J Pediatr"},{"issue":"4","key":"2021121015170889100_B5","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1177\/0885066612465816","article-title":"Fluid management in acute kidney injury.","volume":"29","author":"Goldstein","year":"2014","journal-title":"J Intensive Care Med"},{"issue":"5","key":"2021121015170889100_B6","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1093\/bja\/aeu300","article-title":"Four phases of intravenous fluid therapy: a conceptual model.","volume":"113","author":"Hoste","year":"2014","journal-title":"Br J Anaesth"},{"issue":"1","key":"2021121015170889100_B7","doi-asserted-by":"crossref","first-page":"24","DOI":"10.5492\/wjccm.v3.i1.24","article-title":"Controversies in fluid therapy: type, dose and toxicity.","volume":"3","author":"McDermid","year":"2014","journal-title":"World J Crit Care Med"},{"issue":"3","key":"2021121015170889100_B8","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S0735-6757(00)90119-0","article-title":"Risks of intravenous administration of hypotonic fluids for pediatric patients in ED and prehospital settings: let\u2019s remove the handle from the pump.","volume":"18","author":"Jackson","year":"2000","journal-title":"Am J Emerg Med"},{"issue":"1","key":"2021121015170889100_B9","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1542\/peds.2013-2041","article-title":"Isotonic versus hypotonic maintenance IV fluids in hospitalized children: a meta-analysis.","volume":"133","author":"Wang","year":"2014","journal-title":"Pediatrics"},{"issue":"14","key":"2021121015170889100_B10","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1056\/NEJMra1412877","article-title":"Maintenance intravenous fluids in acutely ill patients.","volume":"373","author":"Moritz","year":"2015","journal-title":"N Engl J Med"},{"issue":"6","key":"2021121015170889100_B11","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1016\/j.jpeds.2013.07.020","article-title":"Association between maintenance fluid tonicity and hospital-acquired hyponatremia.","volume":"163","author":"Carandang","year":"2013","journal-title":"J Pediatr"},{"key":"2021121015170889100_B12","doi-asserted-by":"crossref","first-page":"S30","DOI":"10.1016\/j.amjmed.2006.05.005","article-title":"Incidence and prevalence of hyponatremia.","volume":"119","author":"Upadhyay","year":"2006","journal-title":"Am J Med"},{"issue":"11","key":"2021121015170889100_B13","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1542\/pir.23.11.371","article-title":"Disorders of water metabolism in children: hyponatremia and hypernatremia.","volume":"23","author":"Moritz","year":"2002","journal-title":"Pediatr Rev"},{"issue":"5","key":"2021121015170889100_B14","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1111\/j.1651-2227.1996.tb14084.x","article-title":"Arginine vasopressin and renin in acutely ill children: implication for fluid therapy.","volume":"85","author":"Gerigk","year":"1996","journal-title":"Acta Paediatr"},{"issue":"4","key":"2021121015170889100_B15","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1111\/j.1651-2227.1990.tb11494.x","article-title":"Antidiuretic hormone following surgery in children.","volume":"79","author":"Judd","year":"1990","journal-title":"Acta Paediatr Scand"},{"issue":"5","key":"2021121015170889100_B16","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1542\/peds.19.5.823","article-title":"The maintenance need for water in parenteral fluid therapy.","volume":"19","author":"Holliday","year":"1957","journal-title":"Pediatrics"},{"issue":"3","key":"2021121015170889100_B17","first-page":"455","article-title":"Basal metabolism standards for children.","volume":"55","author":"Talbot","year":"1938","journal-title":"Am J Dis Child"},{"issue":"5","key":"2021121015170889100_B18","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1136\/adc.2003.045047","article-title":"Rubbing salt in the wound.","volume":"89","author":"Hatherill","year":"2004","journal-title":"Arch Dis Child"},{"issue":"5","key":"2021121015170889100_B19","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1542\/peds.113.5.1279","article-title":"Acute hyponatremia related to intravenous fluid administration in hospitalized children: an observational study.","volume":"113","author":"Hoorn","year":"2004","journal-title":"Pediatrics"},{"issue":"5","key":"2021121015170889100_B20","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1542\/peds.2011-0415","article-title":"Hypotonic versus isotonic maintenance fluids after surgery for children: a randomized controlled trial.","volume":"128","author":"Choong","year":"2011","journal-title":"Pediatrics"},{"issue":"6836","key":"2021121015170889100_B21","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1136\/bmj.304.6836.1218","article-title":"Hyponatraemia and death or permanent brain damage in healthy children.","volume":"304","author":"Arieff","year":"1992","journal-title":"BMJ"},{"issue":"12","key":"2021121015170889100_B22","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1007\/s00467-005-1933-6","article-title":"Preventing neurological complications from dysnatremias in children.","volume":"20","author":"Moritz","year":"2005","journal-title":"Pediatr Nephrol"},{"issue":"7289","key":"2021121015170889100_B23","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1136\/bmj.322.7289.780","article-title":"Lesson of the week: acute hyponatraemia in children admitted to hospital: retrospective analysis of factors contributing to its development and resolution.","volume":"322","author":"Halberthal","year":"2001","journal-title":"BMJ"},{"issue":"2","key":"2021121015170889100_B24","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1542\/peds.111.2.227","article-title":"Prevention of hospital-acquired hyponatremia: a case for using isotonic saline.","volume":"111","author":"Moritz","year":"2003","journal-title":"Pediatrics"},{"key":"2021121015170889100_B25","unstructured":"ISMP . Medication safety alert. Plain D5W or hypotonic saline solutions post-op could result in acute hyponatremia and death in healthy children. Available at: ismp.org. Accessed August 14, 2009"},{"issue":"7","key":"2021121015170889100_B26","article-title":"Hospital-acquired acute hyponatremia: two reports of pediatric deaths.","volume":"9","author":"ISMP Canada","year":"2009","journal-title":"ISMP Canada Saf Bul"},{"key":"2021121015170889100_B27","unstructured":"National Patient Safety Agency . Reducing the risk of hyponatraemia when administering intravenous infusions to children. 2007. Available at: www.npsa.nhs.uk\/health\/alerts. Accessed July 6, 2018"},{"issue":"7","key":"2021121015170889100_B28","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1007\/s00431-009-1117-7","article-title":"The impact of the National Patient Safety Agency intravenous fluid alert on iatrogenic hyponatraemia in children.","volume":"169","author":"Drysdale","year":"2010","journal-title":"Eur J Pediatr"},{"issue":"6","key":"2021121015170889100_B29","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1136\/adc.2006.106377","article-title":"Fluid therapy for children: facts, fashions and questions.","volume":"92","author":"Holliday","year":"2007","journal-title":"Arch Dis Child"},{"issue":"7","key":"2021121015170889100_B30","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1001\/jama.2015.7918","article-title":"Isotonic vs hypotonic intravenous fluids for hospitalized children.","volume":"314","author":"McNab","year":"2015","journal-title":"JAMA"},{"issue":"5","key":"2021121015170889100_B31","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.jped.2014.12.003","article-title":"The effect of NaCl 0.9% and NaCl 0.45% on sodium, chloride, and acid-base balance in a PICU population.","volume":"91","author":"Almeida","year":"2015","journal-title":"J Pediatr (Rio J)"},{"issue":"5","key":"2021121015170889100_B32","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1001\/jamapediatrics.2014.3809","article-title":"Comparison of isotonic and hypotonic intravenous maintenance fluids: a randomized clinical trial.","volume":"169","author":"Friedman","year":"2015","journal-title":"JAMA Pediatr"},{"issue":"12","key":"2021121015170889100_B33","first-page":"CD009457","article-title":"Isotonic versus hypotonic solutions for maintenance intravenous fluid administration in children.","author":"McNab","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"2021121015170889100_B34","unstructured":"National Clinical Guideline Centre (UK) . IV Fluids in Children: Intravenous Fluid Therapy in Children and Young People in Hospital. London, United Kingdom: National Clinical Guideline Centre; 2015. Available at: www.ncbi.nlm.nih.gov\/pubmed\/26741016. Accessed July 6, 2018"},{"issue":"9974","key":"2021121015170889100_B35","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1016\/S0140-6736(14)61459-8","article-title":"140 mmol\/L of sodium versus 77 mmol\/L of sodium in maintenance intravenous fluid therapy for children in hospital (PIMS): a randomised controlled double-blind trial.","volume":"385","author":"McNab","year":"2015","journal-title":"Lancet"},{"key":"2021121015170889100_B36","first-page":"1653","volume-title":"Rudolph\u2019s Pediatrics","author":"NJ","year":"2003","edition":"21st ed."},{"key":"2021121015170889100_B37","first-page":"242","volume-title":"Nelson\u2019s Textbook of Pediatrics","author":"LA","year":"2004","edition":"17th ed."},{"issue":"7","key":"2021121015170889100_B38","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1542\/pir.36-7-274","article-title":"Dehydration: isonatremic, hyponatremic, and hypernatremic recognition and management.","volume":"36","author":"Powers","year":"2015","journal-title":"Pediatr Rev"},{"issue":"1","key":"2021121015170889100_B39","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jpeds.2014.01.040","article-title":"Hypotonic versus isotonic fluids in hospitalized children: a systematic review and meta-analysis.","volume":"165","author":"Foster","year":"2014","journal-title":"J Pediatr"},{"issue":"7","key":"2021121015170889100_B40","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1007\/s00467-014-3033-y","article-title":"Isotonic versus hypotonic saline solution for maintenance intravenous fluid therapy in children: a systematic review.","volume":"30","author":"Padua","year":"2015","journal-title":"Pediatr Nephrol"},{"issue":"2","key":"2021121015170889100_B41","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1097\/PEC.0000000000000352","article-title":"The efficacy of isotonic and hypotonic intravenous maintenance fluid for pediatric patients: a meta-analysis of randomized controlled trials.","volume":"31","author":"Yang","year":"2015","journal-title":"Pediatr Emerg Care"},{"issue":"10","key":"2021121015170889100_B42","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1136\/adc.2005.088690","article-title":"Hypotonic versus isotonic saline in hospitalised children: a systematic review.","volume":"91","author":"Choong","year":"2006","journal-title":"Arch Dis Child"},{"issue":"21","key":"2021121015170889100_B43","doi-asserted-by":"crossref","first-page":"2598","DOI":"10.1001\/jama.1993.03510210084032","article-title":"Users\u2019 guides to the medical literature. II. How to use an article about therapy or prevention. A. Are the results of the study valid? Evidence-Based Medicine Working Group.","volume":"270","author":"Guyatt","year":"1993","journal-title":"JAMA"},{"issue":"1","key":"2021121015170889100_B44","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1001\/jama.1994.03510250075039","article-title":"Users\u2019 guides to the medical literature. II. How to use an article about therapy or prevention. B. What were the results and will they help me in caring for my patients? Evidence-Based Medicine Working Group.","volume":"271","author":"Guyatt","year":"1994","journal-title":"JAMA"},{"key":"2021121015170889100_B45","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0. Updated March 2011","author":"Higgins","year":"2011"},{"issue":"3","key":"2021121015170889100_B46","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1542\/peds.2004-1260","article-title":"Classifying recommendations for clinical practice guidelines.","volume":"114","author":"American Academy of Pediatrics Steering Committee on Quality Improvement and Management","year":"2004","journal-title":"Pediatrics"},{"key":"2021121015170889100_B47","unstructured":"Bridge-Wiz . Guideline quality appraisal. Available at: http:\/\/gem.med.yale.edu\/BRIDGE-Wiz\/BridgeWiz_2.1_AAP.zip. Accessed April 12, 2016"},{"issue":"6","key":"2021121015170889100_B48","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1097\/00007632-199603150-00013","article-title":"Inappropriate secretion of antidiuretic hormone in postoperative scoliosis patients: the role of fluid management.","volume":"21","author":"Brazel","year":"1996","journal-title":"Spine"},{"issue":"6","key":"2021121015170889100_B49","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1136\/archdischild-2011-300221","article-title":"A randomised controlled trial of Hartmann\u2019s solution versus half normal saline in postoperative paediatric spinal instrumentation and craniotomy patients.","volume":"97","author":"Coulthard","year":"2012","journal-title":"Arch Dis Child"},{"issue":"4","key":"2021121015170889100_B50","doi-asserted-by":"crossref","first-page":"281","DOI":"10.5546\/aap.2013.eng.281","article-title":"Hypotonic versus isotonic maintenance fluids in critically ill pediatric patients: a randomized controlled trial [in English and Spanish].","volume":"111","author":"Jorro Bar\u00f3n","year":"2013","journal-title":"Arch Argent Pediatr"},{"issue":"3","key":"2021121015170889100_B51","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1179\/2046905515Y.0000000047","article-title":"A prospective trial comparing isotonic with hypotonic maintenance fluids for prevention of hospital-acquired hyponatraemia.","volume":"36","author":"Flores Robles","year":"2016","journal-title":"Paediatr Int Child Health"},{"issue":"11","key":"2021121015170889100_B52","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1007\/s00467-010-1600-4","article-title":"Intravenous fluid regimen and hyponatraemia among children: a randomized controlled trial.","volume":"25","author":"Kannan","year":"2010","journal-title":"Pediatr Nephrol"},{"issue":"6","key":"2021121015170889100_B53","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1097\/PCC.0b013e31818d3192","article-title":"The use of isotonic fluid as maintenance therapy prevents iatrogenic hyponatremia in pediatrics: a randomized, controlled open study.","volume":"9","author":"Monta\u00f1ana","year":"2008","journal-title":"Pediatr Crit Care Med"},{"issue":"2","key":"2021121015170889100_B54","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.jpeds.2009.07.059","article-title":"Prevention of hyponatremia during maintenance intravenous fluid administration: a prospective randomized study of fluid type versus fluid rate.","volume":"156","author":"Neville","year":"2010","journal-title":"J Pediatr"},{"issue":"1","key":"2021121015170889100_B55","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s12098-015-1791-6","article-title":"Isotonic versus hypotonic parenteral maintenance fluids in very severe pneumonia.","volume":"83","author":"Ramanathan","year":"2016","journal-title":"Indian J Pediatr"},{"issue":"8","key":"2021121015170889100_B56","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1111\/j.1651-2227.2011.02209.x","article-title":"Hypotonic versus isotonic maintenance fluids in critically ill children: a multicenter prospective randomized study.","volume":"100","author":"Rey","year":"2011","journal-title":"Acta Paediatr"},{"key":"2021121015170889100_B57","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1186\/1471-2431-11-82","article-title":"A randomized controlled trial of isotonic versus hypotonic maintenance intravenous fluids in hospitalized children.","volume":"11","author":"Saba","year":"2011","journal-title":"BMC Pediatr"},{"issue":"12","key":"2021121015170889100_B58","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1007\/s13312-014-0542-5","article-title":"Safety and efficacy of isotonic (0.9%) vs. hypotonic (0.18%) saline as maintenance intravenous fluids in children: a randomized controlled trial.","volume":"51","author":"Shamim","year":"2014","journal-title":"Indian Pediatr"},{"issue":"1\u20132","key":"2021121015170889100_B59","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/j.1440-1754.2007.01254.x","article-title":"Randomised controlled trial of intravenous maintenance fluids.","volume":"45","author":"Yung","year":"2009","journal-title":"J Paediatr Child Health"},{"issue":"5","key":"2021121015170889100_B60","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.jped.2015.01.004","article-title":"Comparison of two maintenance electrolyte solutions in children in the postoperative appendectomy period: a randomized, controlled trial.","volume":"91","author":"Valad\u00e3o","year":"2015","journal-title":"J Pediatr (Rio J)"},{"issue":"12","key":"2021121015170889100_B61","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1111\/j.1440-1754.2005.00760.x","article-title":"Hyponatraemia and seizures in oncology patients associated with hypotonic intravenous fluids.","volume":"41","author":"Duke","year":"2005","journal-title":"J Paediatr Child Health"},{"issue":"4","key":"2021121015170889100_B62","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1038\/ki.2012.459","article-title":"Mild hyponatremia is associated with an increased risk of death in an ambulatory setting.","volume":"83","author":"Gankam-Kengne","year":"2013","journal-title":"Kidney Int"},{"issue":"1","key":"2021121015170889100_B63","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1530\/EJE-15-0111","article-title":"Hyponatremia and mortality risk: a Danish cohort study of 279\u200a508 acutely hospitalized patients.","volume":"173","author":"Holland-Bill","year":"2015","journal-title":"Eur J Endocrinol"},{"issue":"8","key":"2021121015170889100_B64","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1002\/jhm.1973","article-title":"Evaluation of incremental healthcare resource burden and readmission rates associated with hospitalized hyponatremic patients in the US.","volume":"7","author":"Amin","year":"2012","journal-title":"J Hosp Med"},{"issue":"8","key":"2021121015170889100_B65","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/j.amjmed.2016.03.007","article-title":"The economic burden of hyponatremia: systematic review and meta-analysis.","volume":"129","author":"Corona","year":"2016","journal-title":"Am J Med"},{"key":"2021121015170889100_B66","doi-asserted-by":"crossref","first-page":"2054358117692560","DOI":"10.1177\/2054358117692560","article-title":"Associations between fluid balance and outcomes in critically ill children: a protocol for a systematic review and meta-analysis.","volume":"4","author":"Alobaidi","year":"2017","journal-title":"Can J Kidney Health Dis"},{"issue":"1","key":"2021121015170889100_B67","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s12098-014-1436-1","article-title":"Isotonic intravenous maintenance fluid reduces hospital acquired hyponatremia in young children with central nervous system infections.","volume":"82","author":"Pemde","year":"2015","journal-title":"Indian J Pediatr"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2018-3083\/1076087\/peds_20183083.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2018-3083\/1076087\/peds_20183083.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T18:28:04Z","timestamp":1662488884000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/142\/6\/e20183083\/37529\/Clinical-Practice-Guideline-Maintenance"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,1]]},"references-count":67,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2018,12,1]]},"published-print":{"date-parts":[[2018,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2018-3083","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,1]]},"article-number":"e20183083"}}