From hypotonic maintenance fluid to severe hyponatremia: a case report

Background The principles for maintenance intravenous fluid prescription in children were developed in the 1950s. These guidelines based on the use of hypotonic solutions have been challenged regularly for they seem to be associated with an increased risk of hospital-acquired hyponatremia. Case presentation We report the case of a 4-week-old Caucasian child admitted for acute bronchiolitis who received hypotonic maintenance fluids and developed severe hyponatremia (94 mmol/L) with hyponatremic encephalopathy. Conclusion This clinical situation can serve as a reminder of the latest recommendations from the American Academy of Pediatrics regarding the use of intravenous fluids that promote the use of isotonic fluids in children.

Automated summary

This case report of a 4-week-old Caucasian child admitted for acute bronchiolitis receiving hypotonic maintenance fluids and developing severe hyponatremia highlights the need to reevaluate current guidelines for maintenance intravenous fluid prescription in children. The latest recommendations from the American Academy of Pediatrics emphasize the use of isotonic fluids in children.