SynthesisPediatric nephrology (Berlin, Germany)2015
Isotonic versus hypotonic saline solution for maintenance intravenous fluid therapy in children: a systematic review.
Synthesis in Pediatric nephrology (Berlin, Germany), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Efficacy and safety of isotonic versus hypotonic intravenous maintenance fluids in hospitalized children: an updated systematic review and meta-analysis of randomized controlled trials.Pediatric nephrology (Berlin, Germany) · 2024Pooled it
- Sodium assessment in neonates, infants, and children: a systematic review.European journal of pediatrics · 2022Pooled it
- Intraoperative isotonic balanced versus hypotonic crystalloids on postoperative sodium homeostasis in small children undergoing major neurosurgery: a randomized controlled trial.BMC pediatrics · 2025Trial
- The Clinical and Metabolic Derangements after Using 0.9% Normal Saline as Maintenance Intravenous Fluid in Children.Annals of African medicine · 2026Article
- Comparison of Serum Sodium Levels Following Intravenous Administration of Isotonic and Hypotonic Solutions in Young Children: A Randomized Controlled Trial.Pediatric reports · 2025Article
- A balancing act: drifting away from the reflexive use of "ab"normal saline.Pediatric nephrology (Berlin, Germany) · 2024Review
- Isotonic versus hypotonic intravenous maintenance fluid therapy: what's new?Pediatric nephrology (Berlin, Germany) · 2024Article
- Efficacy and Safety of Isotonic and Hypotonic Intravenous Maintenance Fluids in Hospitalised Children: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.Children (Basel, Switzerland) · 2021Article
- Maintenance Intravenous Fluids in Children, Should We Change?Oman medical journal · 2021Article
- Choice of maintenance intravenous fluids among paediatric residents in Canada.Paediatrics & child health · 2020Article
- Unraveling the Contribution of Fluid Therapy to the Development of Augmented Renal Clearance in a Piglet Model.Frontiers in pharmacology · 2020Article
- Observational
- Calibration of confidence and assessed clinical skills competence in undergraduate paediatric OSCE scenarios: a mixed methods study.BMC medical education · 2018Article
- Management of Diarrhoeal Dehydration in Childhood: A Review for Clinicians in Developing Countries.Frontiers in pediatrics · 2018Review
- Intravenous Fluid Administration and the Survival of Pre hospital Resuscitated out of Hospital Cardiac Arrest Patients in Thailand.Journal of clinical and diagnostic research : JCDR · 2017Article
- Na(+), K(+), Cl(-), acid-base or H2O homeostasis in children with urinary tract infections: a narrative review.Pediatric nephrology (Berlin, Germany) · 2016Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe administration of hypotonic saline solution for maintenance intravenous fluid (IVF) therapy has been the standard of care, but recent evidence has shown this treatment to be associated with hyponatremia-related complications. The aim of this systematic review was to determine which IVF, i.e., a hypotonic or an isotonic saline solution, poses less risk for the development of hyponatremia among hospitalized children who require maintenance IVF therapy.
methodsMedline, Cochrane Library, LILACS, Current Controlled Trials, reference lists, and abstract proceedings were searched for randomized controlled trials (RCTs) comparing hypotonic and isotonic saline solutions for maintenance IVF therapy in hospitalized children. Two reviewers independently assessed all potentially relevant studies and subsequently extracted data and evaluated the methodological quality of the RCTs. Studies were then combined and analyzed using a random effects model.
resultsEleven RCTs met the inclusion criteria. Our analysis of these 11 RCTs showed that among hospitalized children receiving maintenance IVF therapy, isotonic solutions significantly decreased the risk of developing hyponatremia [relative risk (RR) 0.50, 95% confidence interval (CI) 0.40-0.62] without significantly increasing the risk for hypernatremia (RR 0.83, 95% CI 0.41-1.67).
conclusionsCurrent evidence does not support the standard practice of prescribing a hypotonic saline solution as maintenance IVF therapy to hospitalized children. Although there is no single IVF composition ideal for all children, an isotonic saline solution does appear to be the safer choice when maintenance IVF therapy is used in the general pediatric population.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.