The efficacy and safety of isotonic and hypotonic fluids in intravenous maintenance fluid therapy in term newborns: national multicenter observational neofluid study

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dc.contributor.authorOzkan, Hasan
dc.contributor.authorDuman, Nuray
dc.contributor.authorTuzun, Funda
dc.contributor.authorNarter, Fatma
dc.contributor.authorAkyildiz, Can
dc.contributor.authorAltuncu, Emel
dc.contributor.authorSatar, Mehmet
dc.date.accessioned2026-04-04T13:31:18Z
dc.date.available2026-04-04T13:31:18Z
dc.date.issued2024
dc.departmentİnönü Üniversitesi
dc.description.abstractObjective: The objective of this study was to evaluate the efficacy and safety of isotonic and hypotonic intravenous fluids in maintenance fluid therapy for term infants. Methods: This was a multi-centre, prospective, observational study conducted in 21 participating centres from December 30, 2020, to June 30, 2023. The study included term newborns requiring parenteral fluid therapy for maintenance (NCT04781361). The fluid treatment was divided into two groups based on the concentration of sodium in the parenteral fluid, designated as hypotonic (NaCl <130 mmol/L) and isotonic (NaCl = 130-154 mmol/L). The primary outcomes were the change in mean plasma sodium (pNa) levels per hour (triangle pNa mmol/L/h), the incidence of hyponatremia (pNa <135 mmol/L) and hypernatremia (pNa >145 mmol/L), and the occurrence of clinically significant changes in sodium levels (triangle pNa >0.5 mmol/L/h). Results: A total of 420 patients from 21 centers were included. The triangle pNa was negative in the hypotonic fluid group and positive in the isotonic fluid group, with a significant difference between the groups [respectively -0.07 +/- 0.03 (95% CI: -0.13 to -0.02); 0.04 +/- 0.03 (95%CI: -0.02 to 0.09), p = 0.04]. There was no difference between the groups in terms of the development of hypernatremia or a clinically meaningful pNa increase. The hypotonic fluid group had a higher incidence of hyponatremia and a clinically meaningful sodium decrease compared to the isotonic fluid group [7.9% vs. 1.2% (OR:6.5, p:0.03)] and [12.2% vs.4.2% (OR:2.9, p = 0.03)]. Conclusion: Contrary to current understanding, this large-scale study is the first to demonstrate that the use of hypotonic fluids in maintenance fluid therapy for newborns poses a risk of hyponatremia development, whereas isotonic fluid therapy appears safe.
dc.description.sponsorshipTurkish Neonatology Society
dc.description.sponsorshipWe would like to thank the Turkish Neonatology Society for their support of this study.
dc.identifier.doi10.3389/fnut.2024.1410571
dc.identifier.issn2296-861X
dc.identifier.orcid0000-0002-2599-3075
dc.identifier.orcid0000-0002-3328-4156
dc.identifier.orcid0000-0002-3825-858X
dc.identifier.orcid0000-0001-7837-3948
dc.identifier.orcid0000-0002-0411-9610
dc.identifier.orcid0000-0001-5761-4757
dc.identifier.orcid0000-0002-6694-8115
dc.identifier.pmid39376791
dc.identifier.scopus2-s2.0-85206086113
dc.identifier.scopusqualityN/A
dc.identifier.urihttps://doi.org/10.3389/fnut.2024.1410571
dc.identifier.urihttps://hdl.handle.net/11616/108698
dc.identifier.volume11
dc.identifier.wosWOS:001331442800001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherFrontiers Media Sa
dc.relation.ispartofFrontiers in Nutrition
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectnewborn
dc.subjectmaintenance
dc.subjectfluid therapy
dc.subjecttonicity
dc.subjectisotonic
dc.subjecthypotonic
dc.subjecthyponatremia
dc.subjecthypernatremia
dc.titleThe efficacy and safety of isotonic and hypotonic fluids in intravenous maintenance fluid therapy in term newborns: national multicenter observational neofluid study
dc.typeArticle

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