Electrolyte derangements in critically ill children receiving balanced versus unbalanced crystalloid fluid resuscitation

Background Adult studies have demonstrated potential harm from resuscitation with 0.9% sodium chloride (0.9%NaCl), resulting in increased utilization of balanced crystalloids like lactated ringers (LR). The sodium and potassium content of LR has resulted in theoretical safety concerns, although limi...

Celý popis

Uloženo v:

Podrobná bibliografie
Vydáno v:	BMC nephrology Ročník 23; číslo 1; s. 388 - 9
Hlavní autoři:	Stanski, Natalja L., Gist, Katja M., Pickett, Kaci, Brinton, John T., Sadlowski, Jennifer, Wong, Hector R., Mourani, Peter, Soranno, Danielle E., Kendrick, Jessica, Stenson, Erin K.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	London BioMed Central 06.12.2022 BioMed Central Ltd Springer Nature B.V BMC
Témata:	Acidosis Care and treatment Child Chloride Clinical trials Comparative analysis Complications and side effects Critically ill children Crystalloid Solutions - therapeutic use Electrolytes Fluid therapy Fluids Hospitals Humans Hyperkalemia Hyponatremia Informatics Intensive care Intensive care units Internal Medicine Kidney diseases Laboratories Lactated Ringers Medicine Medicine & Public Health Mortality Nephrology Normal distribution Osmoregulation Patients Pediatric intensive care Pediatric research Pediatrics Potassium Prospective Studies Research Design Risk factors Sodium Sodium chloride Solutions (Pharmacy) Variables Water-electrolyte balance (Physiology) United States Hyperkalemia Hyponatremia Lactated Ringers Sodium chloride Acidosis
ISSN:	1471-2369, 1471-2369
On-line přístup:	Získat plný text
Tagy:	Přidat tag Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!

Popis
Shrnutí:	Background Adult studies have demonstrated potential harm from resuscitation with 0.9% sodium chloride (0.9%NaCl), resulting in increased utilization of balanced crystalloids like lactated ringers (LR). The sodium and potassium content of LR has resulted in theoretical safety concerns, although limited data exists in pediatrics. We hypothesized that use of LR for resuscitation would not be associated with increased electrolyte derangements compared to 0.9%NaCl. Methods A prospective, observational cohort study of critically ill children who received ≥ 20 ml/kg of fluid resuscitation and were admitted to two pediatric intensive care units from November 2017 to February 2020. Fluid groups included patients who received > 75% of fluids from 0.9%NaCl, > 75% of fluids from LR, and a mixed group. The primary outcome was incidence of electrolyte derangements (sodium, chloride, potassium) and acidosis. Results Among 559 patients, 297 (53%) received predominantly 0.9%NaCl, 74 (13%) received predominantly LR, and 188 (34%) received a mixture. Extreme hyperkalemia (potassium ≥ 6 mmol/L) was more common in 0.9%NaCl group (5.8%) compared to LR group (0%), p 0.05. Extreme acidosis (pH > 7.1) was more common in 0.9%NaCl group (11%) compared to LR group (1.6%), p 0.016. Conclusions LR is associated with fewer electrolyte derangements compared to 0.9%NaCl. Prospective interventional trials are needed to validate these findings.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Article-2 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	1471-2369 1471-2369
DOI:	10.1186/s12882-022-03009-w