Hypotonic versus isotonic maintenance fluid administration in the pediatric surgical patient

Abstract

Intravenous fluid administration has been occurring for well over one hundred years for a variety of pediatric disease processes. Surprisingly, clinicians have yet to agree upon a standardized intravenous solution. There is ongoing debate regarding the administration of isotonic versus hypotonic fluids as maintenance solutions. In this article, we will review what is known about different maintenance solutions, discuss the potential complications with their use, and summarize the available evidence to help guide clinicians in their choice of maintenance fluids for their patients.

Keywords: Hyperchloremic acidosis; Hyponatremia; Hypotonic; Intravenous fluids; Isotonic.