RT Journal Article SR Electronic T1 Hyponatraemia despite isotonic maintenance fluid therapy: a time series intervention study JF Archives of Disease in Childhood JO Arch Dis Child FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health SP 491 OP 495 DO 10.1136/archdischild-2019-318555 VO 106 IS 5 A1 Milan Chromek A1 Åsa Jungner A1 Niclas Rudolfson A1 David Ley A1 Detlef Bockenhauer A1 Lars Hagander YR 2021 UL http://adc.bmj.com/content/106/5/491.abstract AB Objective To examine the prevalence of dysnatraemias among children admitted for paediatric surgery before and after a change from hypotonic to isotonic intravenous maintenance fluid therapy.Design Retrospective consecutive time series intervention study.Setting Paediatric surgery ward at the Children’s Hospital in Lund, during a 7-year period, 2010–2017.Patients All children with a blood sodium concentration measurement during the study period were included. Hypotonic maintenance fluid (40 mmol/L NaCl and 20 mmol/L KCl) was used during the first 3 years of the study (646 patients), and isotonic solution (140 mmol/L NaCl and 20 mmol/L KCl) was used during the following period (807 patients).Main outcome measures Primary outcomes were sodium concentration and occurrence of hyponatraemia (<135 mmol/L) or hypernatraemia (>145 mmol/L).Results Overall, the change from hypotonic to isotonic intravenous maintenance fluid therapy was associated with a decreased prevalence of hyponatraemia from 29% to 22% (adjusted OR 0.65 (0.51–0.82)) without a significantly increased odds for hypernatraemia (from 3.4% to 4.3%, adjusted OR 1.2 (0.71–2.1)). Hyponatraemia <130 mmol/L decreased from 6.2% to 2.6%, and hyponatraemia <125 mmol/L decreased from 2.0% to 0.5%.Conclusions Routine use of intravenous isotonic maintenance fluids was associated with lower prevalence of hyponatraemia, although hyponatraemia still occurred in over 20% of patients. We propose that the composition and the volume of administered fluid need to be addressed.Data may be obtained from a third party and are not publicly available.