A balancing act: drifting away from the reflexive use of "ab"normal saline.

Linda Wang, Celeste Dixon, Jennifer Nhan, Aadil Kakajiwala

Abstract readReview

In one paragraph

Review in Pediatric nephrology (Berlin, Germany), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

0.3field-weighted citation impact, top 42% of its field

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Linda WangDepartment of Pediatrics, Division of Nephrology, Children's National Hospital, Washington, DC, USA. lwang4@childrensnational.org.ORCID 0009-0009-3015-0468

Celeste DixonDepartment of Pediatrics, Division of Critical Care Medicine, Children's National Hospital, Washington, DC, USA.

Jennifer NhanDepartment of Pediatrics, Division of Nephrology, Children's National Hospital, Washington, DC, USA.

Aadil KakajiwalaDepartment of Pediatrics, Division of Nephrology, Children's National Hospital, Washington, DC, USA.

Children's National · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Maintenance intravenous fluids are the most frequently ordered medications for hospitalized children. Since the American Association of Pediatrics published national guidelines, there has been an increased reflexive use of isotonic solutions, especially 0.9% saline, as a prophylaxis against hyponatremia. In this educational review, we discuss the potential deleterious effects of using 0.9% saline, including the development of hyperchloremia, metabolic acidosis, acute kidney injury, hyperkalemia, and a proinflammatory state. Balanced solutions with anion buffers cause relatively minimal harm when used in most children. While the literature supporting one fluid choice over the other is variable, we highlight the benefits of balanced solutions over saline and the importance of prescribing fluid therapy that is individualized for each patient.

Indexed as

Fluid TherapyHyponatremiaSaline SolutionAcidosisAcute Kidney InjuryChildHumansHyperkalemiaSaline Solution0.9% salineBalanced solutionsHyperchloremiaIntravenous fluids

Identifiers

PMID38233719

DOI10.1007/s00467-023-06271-8

OpenAlexW4390978824

What OpenQuestion holds

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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.