Acute Hyponatremia following Hypotonic Intravenous Fluid in a 4-year-old Child

Abstract

ABSTRACT Hyponatremia is the most frequently encountered electrolyte disorder in hospitalized patients. It develops due to either surplus water or decreased sodium in the extracellular fluid. In children, the source of excess water is frequently the administration of hypotonic intravenous fluids. The current recommendations of hypotonic maintenance fluids may be appropriate for a healthy child, but may not apply to hospitalized children who are more likely to have a nonosmotic stimulus for antidiuretic hormone (ADH) production, such as anxiety, stress, pain, etc. Fall in plasma sodium concentration acutely to < 130 mmol/L leads to brain cell swelling and devastating neurological outcome. Previous studies have reported the potential harm with these solutions and the need to reconsider their routine use in children. We present a case report of 4-year-old child, admitted with head injury and normal CT brain, who developed hyponatremic convulsions following administration of Isolyte-P as maintenance fluid as per standard guidelines. How to cite this article Rustagi P, Dalvi NP, Tendolkar BA, Kotak S. Acute Hyponatremia following Hypotonic Intravenous Fluid in a 4-year-old. Res Inno in Anesth 2016;1(2):63-64.