Which of the following maintenance IV fluid choices is recommended for most hospitalized children beyond the neonatal period, in order to prevent hospital-acquired hyponatremia?
- A 0.18% saline with 4% dextrose at full maintenance rate
- B Hypotonic solutions such as 0.45% saline with 5% dextrose
- C Isotonic solutions such as 0.9% saline or balanced salt solutions ✓
- D 5% dextrose in water at half-maintenance rate
Correct answer: C. Isotonic solutions such as 0.9% saline or balanced salt solutions
Explanation
Routine use of hypotonic maintenance fluids in hospitalized children produces a fall in serum sodium because ADH is commonly elevated by pain, nausea, drugs and illness, preventing water excretion. Multiple randomized trials and major pediatric societies now favor isotonic maintenance fluids, which reduce hospital-acquired hyponatremia without causing significant hypernatremia. Options B, A and D are the traditional hypotonic prescriptions that carry exactly the risk being avoided.
Reference: Nelson Textbook of Pediatrics, 22nd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.