Abstract

ALEGRIA, Ana et al. Hyponatremia during the first 24 hours following minor ear, nose and throat surgery secondary to the use of ringer lactate solution . Arq Med [online]. 2007, vol.21, n.3-4, pp.71-76. ISSN 2183-2447.

Salt and water are probably the commonest therapeutic agents given to hospitalized patients. Hyponatremia is defined as a plasma sodium concentration (PNa)< 136 mmol/l and has been recognized, in the last decades, as the most commonelectrolyte disturbance related to hypotonic fluids received by children. Methods: 70 children who had ear, nose and throat (ENT) surgery under general anesthes were studied. Ringer Lactate was used for fluid requirement during the peri-operative period. Fluid therapy was suspended 6 hours after surgery, and oral fluids and feeding were started. A general linear model for longitudinal data was used. Results: The mean change in sodium concentration in the first 6 hours after surgery was -0.116 mmol/L per hour and is significant (p=0.041). If parenteral fluid therapy had continued longer, there is evidence that hyponatremia would develop at approximately 20 hours postoperatively. Conclusion: Children receiving isotonic fluids are at risk of hyponatremia. Intravenous fluid therapy should be individualized. Proper care and evaluation with daily weighing, checking for signs of edema, monitoring intake/output and vital signs, and regular checks of plasma sodium concentration are fundamental. There is no agreement about which fluid is better and how much fluid is ideal to prevent hospital-acquired hyponatremia in children.

Keywords : hyponatremia; fluid therapy; intravenous; children; antidiuretic hormone.

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