Reply to correspondence letter ‘don't forget potassium!’ by K. Kaneko

Drysdale, Simon B.; Coulson, Timothy; Cronin, Natalie; Manjaly, Zita-Rose; Piyasena, Chinthika; North, Adam; Ford‐Adams, Martha; Broughton, Simon

doi:10.1007/s00431-010-1168-9

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“…Though I agree in general that hypotonic solution should be replaced by isotonic solution for sick children, 0.9% NaCl might have the risk of development of iatrogenic hypokalemia because it does not contain potassium [36]. According to the study by Holliday and Segar, daily intake of potassium is recommended to be 2.0 mEq/100 cal [23], and Armon et al reported that 23% of children receiving intravenous fluid therapy were hyopokalemic, of whom, 24% were not receiving potassium in their intravenous fluid [37].…”

Section: Prevention Of Hospital-acquired Hyponatremiamentioning

confidence: 99%

Hospital-acquired hyponatremia in children: Epidemiology, pathophysiology, and prevention

Kaneko

2010

J Pediatr Biochem

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Recent observations have revealed that otherwise healthy children with acute illnesses are prone to hyponatremia due to increased arginine vasopressin production by non-osmotic stimuli. Concern has recently been raised about the potential for iatrogenic hyponatremia as a result of maintenance fluid therapy for those children. To minimize the risk of development of hospital-acquired hyponatremia in sick children receiving maintenance fluid therapy, the routine practice of administration of hypotonic fluids (e.g., 0.18% NaCl with 4% glucose: Na 31 mEq/L, Cl 31 mEq/L) should be abandoned. Instead, isotonic solution, such as 0.9% NaCl (Na 154 mEq/L, K 0 mEq/L, Cl 154 mEq/L) or Hartmann's solution (Na 130 mEq/L, K 4 mEq/L, Cl 110 mEq/L) should be administered. In addition, it must be noted that close monitoring of the children with daily weights, frequent vitals, strict intake and output measurement, and daily chemistries, especially during the first 72 h of parenteral fluid therapy is essential.

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Section: Prevention Of Hospital-acquired Hyponatremiamentioning

confidence: 99%

Hospital-acquired hyponatremia in children: Epidemiology, pathophysiology, and prevention

Kaneko

2010

J Pediatr Biochem

View full text Add to dashboard Cite

show abstract

Reply to correspondence letter ‘don't forget potassium!’ by K. Kaneko

Cited by 1 publication

References 3 publications

Hospital-acquired hyponatremia in children: Epidemiology, pathophysiology, and prevention

Hospital-acquired hyponatremia in children: Epidemiology, pathophysiology, and prevention

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