{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T21:01:56Z","timestamp":1768251716572,"version":"3.49.0"},"reference-count":15,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,5,17]],"date-time":"2020-05-17T00:00:00Z","timestamp":1589673600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health","award":["n.a."],"award-info":[{"award-number":["n.a."]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Maintenance with isotonic fluids is recommended in children with gastroenteritis and failure of oral rehydration therapy. However, little is known on the short-term effects of the commonly prescribed intravenous solutions on metabolic balance in children. The aim of this study is to report on our experience with normal saline, dextrose-supplemented saline and lactated Ringer solution. Methods: A retrospective analysis from the charts of all previously apparently healthy children with acute gastroenteritis, mild to moderate dehydration and failure of oral rehydration, evaluated between January 2016 and December 2019 at our institution, was performed. Subjects prescribed the above-mentioned maintenance intravenous fluids and with blood testing immediately before starting fluid therapy and 4\u20136 h later, were eligible. The changes in bicarbonate, ionized sodium, potassium, chloride, anion gap and glucose were investigated. Kruskal\u2013Wallis test with the post-hoc Dunn\u2019s comparison and the Fisher exact test were applied. Results: A total of 134 out of 732 children affected by acute gastroenteritis were included (56 patients were prescribed normal saline, 48 dextrose-supplemented normal saline and 30 lactated Ringer solution). The effect of the three solutions on sodium and potassium was similar. As compared to non-supplemented normal saline (+0.4 (\u22121.9 \u2013 +2.2) mmol\/L), dextrose-supplemented normal saline (+1.5 (+0.1 \u2013 +4.2) mmol\/L) and lactated Ringer (+2.6 (+0.4 \u2013 +4.1) mmol\/L) solution had a positive effect on plasma bicarbonate. Finally, the influence of dextrose-supplemented saline on blood glucose was different (+1.1 (+0.3 \u2013 +2.2) mmol\/L) compared to that observed in cases hydrated with non-supplemented saline (\u22120.4 (\u22121.2 \u2013 +0.3) mmol\/L) or lactated Ringer solution (\u22120.4 (\u22121.2 \u2013 +0.1) mmol\/L). Conclusions: This study points out that maintenance intravenous therapies using normal saline, dextrose-supplemented saline or lactated Ringer solution have different effects on metabolic balance. A personalized fluid therapy that takes into account the clinical and biochemical variables is advised.<\/jats:p>","DOI":"10.3390\/nu12051449","type":"journal-article","created":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T02:43:42Z","timestamp":1589769822000},"page":"1449","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Maintenance Fluid Therapy with Saline, Dextrose-Supplemented Saline or Lactated Ringer in Childhood: Short-Term Metabolic Effects"],"prefix":"10.3390","volume":"12","author":[{"given":"Alessandra","family":"Ricciuti","sequence":"first","affiliation":[{"name":"Pediatric Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3829-4254","authenticated-orcid":false,"given":"Gregorio P.","family":"Milani","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"},{"name":"Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP), 20126 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Tarantino","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Ghilardi","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastiano A.G.","family":"Lava","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, and University of Lausanne, 1010 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Alberzoni","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario G.","family":"Bianchetti","sequence":"additional","affiliation":[{"name":"Universit\u00e0 della Svizzera Italiana, 6900 Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5006-0832","authenticated-orcid":false,"given":"Carlo","family":"Agostoni","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"},{"name":"Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP), 20126 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,17]]},"reference":[{"key":"ref_1","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. 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