Niveles séricos de sodio en el paciente pediátrico manejado con soluciones salinas al 0.45% Vs 0.30%


Históricamente el manejo hídrico pediátrico es con soluciones hipotónicas, actualmente se recomiendan isotónicas por riesgo de hiponatremia iatrogénica.

Objetivo: Identificar hiponatremia en pacientes pediátricos manejados con soluciones IV al 0.30% y 0.45%.

Estudio: Ensayo clí­nico controlado.

Metodología: Se asignó aleatoriamente 60 pacientes entre 1 y 14 años, en ayuno postquirúrgico con soluciones IV, en dos grupos, ambos recibieron soluciones salinas al 0.30% (A) o 0.45% (B). Se midió sodio sérico a las 24 y 48hrs. Se realizó análisis estadístico con X2.

Resultados: Grupo A promedió sodio a las 24 horas de 137 mmol/L, a las 48, 136 mmol/L; El grupo B presentó a las 24 horas 138 mmol/L, a las 48, 139 mmol/L. 6.7% de los pacientes del grupo A presentó hiponatremia a las 24 horas (X2=0.5, p=0.47). 3.3% del grupo A y 0% del B presentó hiponatremia a las 48 horas (X2=0.0, p=1.0). A las 24 y 48 horas 3,3% del grupo A y 6.7% del B presentaron hipernatremia (X2=0.0, p=1.0).

Conclusión: No hay asociación entre soluciones al 0.30% o 0.45% con hiponatremia o hipernatremia.

Palabras clave: Hiponatremia, solución hipotónica, pacientes pediátricos.

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