Review: hypotonic solutions increase acute hyponatraemia in children receiving standard intravenous maintenance therapy.

Study selection and assessment: controlled trials, cohort studies, and case-control studies that evaluated adverse events (acute plasma sodium derangements and their attributed morbidity) associated with use of hypotonic (containing ,0.9% sodium chloride) or isotonic (containing 0.9% sodium chloride or Ringers Lactate) IV maintenance solutions in children 1 month to 17 years of age who had been admitted to hospital for any medical or surgical condition. Patients with pre-existing hyponatraemia or comorbidities that result in sodium derangements were excluded. 6 studies (2 randomised controlled trials, 1 non-randomised controlled trial, 2 cohort studies, and 1 case-control study) (n = 404) met the selection criteria. Quality assessment of individual studies was based on criteria appropriate for the study design.