A retrospective cohort study published in BMJ Paediatrics Open evaluated the safety and efficacy of isotonic and hypotonic intravenous fluids in 138 term newborns with hypernatremic dehydration requiring intravenous rehydration. The study analyzed infants treated with 0.9% NaCl (n=44), 0.45% NaCl (n=54), or 0.2% NaCl (n=40) between 2014 and 2023. Serum sodium levels declined significantly in all groups following treatment. However, the hourly sodium reduction was slowest with 0.9% NaCl (0.08 mmol/L/hour) compared with 0.45% NaCl (0.24 mmol/L/hour) and 0.2% NaCl (0.42 mmol/L/hour) (p<0.001).
Clinically significant sodium correction exceeding 0.5 mmol/L/hour occurred in 6.8%, 13.0%, and 42.5% of infants, respectively (p<0.001). Despite these differences, no significant differences in mortality or morbidity were observed between treatment groups. Isotonic fluids may offer a safer approach…
