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Effect of 0.9% saline in 5% dextrose, Plasma-Lyte 148 and Isolyte-P used as intravenous maintenance fluids on the electrolyte status of non-critically ill hospitalised children: Results of a prospective randomised open label study

Authors:

Balaji Chinnasami,

SRM Institute of Science and Technology, Potheri, Kattankulathur, Tamil Nadu, IN
About Balaji
Professor Department of Paediatrics, SRM Medical College Hospital and Research Centre
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Pulim Manoj Kumar Reddy ,

Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh,, IN
About Pulim
Assistant Professor, Department of Paediatrics
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R. Dhinakaran,

SRM Institute of Science and Technology, Potheri, Kattankulathur, Tamil Nadu, IN
About R.
Assistant Professor, SRM Medical College Hospital and Research Centre
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M. S. K. M. Chaitanya,

SRM Institute of Science and Technology, Potheri, Kattankulathur, Tamil Nadu, IN
About M. S. K. M.
Pharm D, SRM College of Pharmacy
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G. Vijayakrishnan

SRM Institute of Science and Technology, Potheri, Kattankulathur, Tamil Nadu,, IN
About G.
Associate Professor Department of Community Medicine
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Abstract

Background: Consensus regarding the correct type of maintenance intravenous (IV) fluid in non-critically ill stable children is yet to be reached. Most previous studies are based on children admitted in intensive care units (ICUs) or post-operative wards.


Objectives: To compare the effects of three different IV fluids, namely 0.18% saline in 5% dextrose (Isolyte-P), 0.9% saline in 5% dextrose (DNS) and Plasma-Lyte 148 on the change in electrolyte levels in stable children admitted in a general ward after giving them maintenance fluids for 48 hours.


Method: Our study was a non-blinded, randomised pragmatic trial conducted at the paediatric general ward of the SRM Medical College and Hospital, Kattankulathur, South India from June 2018 to March 2019. Eligible children (n=212) were between 3 months to 12 years old, requiring hospitalisation due to their illness and needing IV maintenance fluids for a minimum of 48 hours. Children requiring ICU admissions, children needing postoperative care, children with dyselectrolytaemia and children on drugs or suffering from diseases that altered plasma sodium levels were not included in the study.


Intervention: Enrolled children, using computer generated codes, were randomised equally (50 in each group) to groups receiving Isolyte P, DNS or Plasma-Lyte148 as IV fluids for a minimum of 48 hours.

Main outcomes and measures: Main outcome was difference in change in sodium among the three IV fluids after 48 hours of giving them as maintenance fluids. Secondary outcomes were to find the difference in other biochemical parameters like urea, creatinine, potassium, chloride and bicarbonate at the same endpoint.


Statistical analysis: Pre- and post-values of biochemical parameters were tested for significance using paired sample t-test. Comparison of the three fluid groups was done by ANOVA.


Results: After 48 hours, the serum sodium levels in DNS, Isolyte-P and Plasma-Lyte148 groups had increased on an average by 0.48 meq/L, 0.8 meq/L and 0.64 meq/L respectively from the baseline and the difference was not statistically significant (p = 0.854). Mean change in potassium values were -0.142 meq/L, 0.188 meq/L and 0.230 meq/L in DNS, Isolyte-P and Plasma-lyte148 respectively. There was a significant difference in potassium among the fluids as potassium fell in DNS group (p = 0.001). Urea, creatinine and bicarbonate levels improved in all three groups. There were no clinically observable adverse events due to dyselectrolytaemia among the three groups.


Conclusions: There was no significant change in sodium after giving any of the three fluids Isolyte-P, DNS or Plasma-Lyte 148 in children who were clinically stable.


Sri Lanka Journal of Child Health, 2022; 51(1): 111-118

How to Cite: Chinnasami, B., Reddy, P.M.K., Dhinakaran, R., Chaitanya, M.S.K.M. and Vijayakrishnan, G., 2022. Effect of 0.9% saline in 5% dextrose, Plasma-Lyte 148 and Isolyte-P used as intravenous maintenance fluids on the electrolyte status of non-critically ill hospitalised children: Results of a prospective randomised open label study. Sri Lanka Journal of Child Health, 51(1), pp.111–118. DOI: http://doi.org/10.4038/sljch.v51i1.10008
Published on 05 Mar 2022.
Peer Reviewed

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