{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T01:16:25Z","timestamp":1776820585091,"version":"3.51.2"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T00:00:00Z","timestamp":1625529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p><jats:bold>Objetive:<\/jats:bold> We sought to determine the association between maintenance intravenous solutions and the presence of hyponatremia in children in pediatric intensive care (PICU).<\/jats:p><jats:p><jats:bold>Materials and Methods:<\/jats:bold> An analytical observational study in children hospitalized in the PICU between January 2015 and December 2018. Patients who received maintenance fluids within the first 48 h after admission and who had at least two serum sodium levels drawn during this time were included.<\/jats:p><jats:p><jats:bold>Measurements and Main Results:<\/jats:bold> A total of 1,668 patients were admitted to the PICU during the study period, 503 of whom met the inclusion criteria. The median age was 24 months (IQR 8\u201396) and 50.9% were female. Altogether, 24.1% of the children developed hyponatremia; it was more frequent in those who received hypotonic solutions (63 vs. 37%; OR 1.41 95% CI 0.92, 2.15 <jats:italic>p<\/jats:italic> = 0.106), who also had a longer hospital stay (20 vs. 14 days, difference in means 8 days, 95% CI 2.67, 13.3, <jats:italic>p<\/jats:italic> = 0.001). Children who received loop diuretics and those who were post-operative had a greater risk of developing hyponatremia if they received hypotonic solutions (aOR 2.1 95% CI 1.41, 3.0, <jats:italic>p<\/jats:italic> = 0.000). Those with balanced isotonic solutions had a lower risk of developing hyponatremia (aOR 0.59 95% CI 0.35, 0.99, <jats:italic>p<\/jats:italic> = 0.004) and hyperchloremia (aOR 0.51 95% CI 0.34, 0.77, <jats:italic>p<\/jats:italic> = 0.000), adjusted for disease severity. A greater risk of death was found in the group with severe hyponatremia &amp;lt;130 mEq\/L (aOR 9.75 95% CI 1.64\u201358.15; <jats:italic>p<\/jats:italic> = 0.01).<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Hyponatremia associated with the use of hypotonic maintenance solutions occurs in one out of four children in intensive care. The use of these solutions is associated with a longer hospital stay, and the main risk groups are post-operative patients and those who receive loop diuretics. Clinical studies are needed to determine which maintenance solutions have the greatest efficacy and safety in critically ill children.<\/jats:p>","DOI":"10.3389\/fped.2021.691721","type":"journal-article","created":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T13:06:06Z","timestamp":1625576766000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between Hyponatremia and Maintenance Intravenous Solutions in Critically Ill Children: A Retrospective Observational Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Jaime","family":"Fern\u00e1ndez-Sarmiento","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Alejandra","family":"Echeverri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Jimenez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Alejandra","family":"Joachim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Andr\u00e9s-Jagua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,7,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","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 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