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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Isotonic versus hypotonic maintenance IV fluids in hospitalized children: A meta-analysis
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Isotonic versus hypotonic maintenance IV fluids in hospitalized children: A meta-analysis

机译：等渗与低渗维持静脉输液的住院儿童：一项荟萃分析

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摘要

OBJECTIVE: To assess evidence from randomized controlled trials (RCTs) on the safety of isotonic versus hypotonic intravenous (IV) maintenance fluids in hospitalized children. METHODS: We searched PubMed, Embase, Cochrane Library, and clinicaltrials. gov (up to April 11, 2013) for RCTs that compared isotonic to hypotonic maintenance IV fluid therapy in hospitalized children. Relative risk (RR), weighted mean differences, and 95% confidence intervals (CIs) were calculated based on the effects on plasma sodium (pNa). The risk of developing hyponatremia (pNa <136 mmol/L), severe hyponatremia (pNa <130 mmol/L), and hypernatremia (pNa >145 mmol/L) was evaluated. We adopted a random-effects model in all meta-analyses. Sensitivity analyses by missing data were also performed. RESULTS: Ten RCTs were included in this review. The meta-analysis showed significantly higher risk of hypotonic IV fluids for developing hyponatremia (RR 2.24, 95% CI 1.52 to 3.31) and severe hyponatremia (RR 5.29, 95% CI 1.74 to 16.06). There was a significantly greater fall in pNa in children who received hypotonic IV fluids (-3.49 mmol/L versus isotonic IV fluids, 95% CI -5.63 to -1.35). No significant difference was found between the 2 interventions in the risk of hypernatremia (RR 0.73, 95% CI 0.22 to 2.48). None of the findings was sensitive to imputation of missing data. CONCLUSIONS: Isotonic fluids are safer than hypotonic fluids in hospitalized children requiring maintenance IV fluid therapy in terms of pNa.
机译：目的：评估随机对照试验（RCT）在住院儿童中等渗与低渗静脉注射（IV）维持液安全性的证据。方法：我们搜索了PubMed，Embase，Cochrane文库和临床试验。 gov（截至2013年4月11日），用于比较住院儿童的等渗与低渗维持IV液体疗法的比较。基于对血浆钠（pNa）的影响，计算了相对风险（RR），加权平均差异和95％置信区间（CIs）。评估发生低钠血症（pNa <136 mmol / L），严重低钠血症（pNa <130 mmol / L）和高钠血症（pNa> 145 mmol / L）的风险。我们在所有荟萃分析中均采用了随机效应模型。还通过丢失数据进行了敏感性分析。结果：十项随机对照试验被纳入本评价。荟萃分析显示，低渗静脉输液发生低钠血症（RR 2.24，95％CI 1.52至3.31）和严重低钠血症（RR 5.29，95％CI 1.74至16.06）的风险明显较高。接受低渗静脉输液的儿童中pNa的下降幅度更大（与等渗静脉输液相比，-3.49 mmol / L，95％CI -5.63至-1.35）。两种干预措施在高钠血症风险之间没有发现显着差异（RR 0.73，95％CI 0.22至2.48）。没有任何发现对缺失数据的估算敏感。结论在需要维持静脉输液治疗的住院儿童中，等渗液比低渗液更安全。

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