Hidratación de mantenimiento en niños agudamente enfermos

Erdwis Pérez Pintado

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Resumen

Introducción: un aspecto crítico del cuidado de pacientes agudamente enfermos es la administración de líquidos intravenosos. Existe poco consenso sobre la tasa más apropiada de administración y la composición de los líquidos intravenosos. La práctica con respecto a los fluidos de mantenimiento varía ampliamente.
Objetivo: describir la composición y las tasas de administración más apropiadas de los líquidos intravenosos.
Método: se realizó una revisión en Medline/Pubmed, Elseiver y Scielo de los artículos publicados en el período comprendido entre 1953-2016. No hubo restricción de idioma. Los términos de búsqueda fueron: fluidos intravenosos, hiponatremia y niños.
Desarrollo: los fluidos hipotónicos siguen siendo recomendados en pacientes agudamente enfermos, a pesar de la fuerte asociación entre su uso y el desarrollo de hiponatremia. La abrumadora evidencia prospectiva hasta la fecha, indica que las soluciones de mantenimiento isotónicas son más seguras que los fluidos hipotónicos en la protección de la hiponatremia moderada y severa.
Consideraciones finales: es hora de que dejemos de usar fluidos hipotónicos en estados de enfermedad asociados con exceso de arginina vasopresina, y no existe razón para que esta práctica continúe. Esta información debe ser difundida por la Academia, pues los profesionales involucrados en el cuidado de niños enfermos necesitan ser informados y entrenados adecuadamente. 

Referencias

- Moritz M L, Ayus J C. Maintenance Intravenous Fluids in Acutely Ill Patients. N Engl J Med [Internet]. 2015 Oct [cited March 8 2017]; 373(14): [Above 11p.]. Available from: http://www.nejm.org/doi/pdf/10.1056/NEJMra1412877

- Spasovski G, Vanholder R, Allolio B, Annane D, Ball S, Bichet D. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur J Endocrinol [Internet]. 2014 Feb [cited March 6 2017]; 17(1): [Above 47p.]. Available from: http://www.eje-online.org/content/170/3/G1.long

- Nagler E V, Vanmassenhove J, van der Veer S N, Nistor I, Van Biesen W, Webster A C, Vanholder R. Diagnosis and treatment of hyponatremia: a systematic review of clinical practice guidelines and consensus statements. BMC Medicine [Internet]. 2014 [cited March 7 2017]; 12(1): [Above 16p.]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276109/pdf/12916_2014_Article_231.pdf

- Verbalis J G, Goldsmith S R, Greenberg A, Korzelius C, Schrier R W, Sterns R H et al. Diagnosis, Evaluation, and Treatment of Hyponatremia: Expert Panel Recommendations. Am J Med [Internet]. 2013 Oct [cited March 7 2017]; 126(10 Suppl 1): [Above 42p.]. Available from: http://ac.els-cdn.com/S0002934313006050/1-s2.0-S0002934313006050-main.pdf?_tid=1d4e3b9e-0347-11e7-ad38-00000aacb361&acdnat=1488899142_003859f4cfb335e47507e8a95b0fb963

- Flores Robles CM , Cuello García CA.. A prospective trial comparing isotonic with hypotonic maintenance fluids for prevention of hospital-acquired hyponatraemia. Paediatr Int Child Health [Internet]. 2016 Aug [cited March 3 2017]; 36(3): [Above 7p.]. Available from:

http://www.tandfonline.com/doi/pdf/10.1179/2046905515Y.0000000047

- Padua A P, Macaraya J R, Dans L F, Anacleto Jr. F E . Isotonic versus hypotonic saline solution for maintenance intravenous fluid therapy in children: a systematic review. Pediatr Nephrol [Internet]. 2015 [cited March 7 2017] 30: [Above 10p.]. Available from: http://link.springer.com/article/10.1007%2Fs00467-014-3033-y

- Moritz M L, Ayus J C. Management of hyponatremia in Various Clinical Situations. Curr Treat Options Neurol [Internet]. 2014 [cited March 8 2017]; 16: 310. [Above 14p.]. Available from: http://link.springer.com/article/10.1007%2Fs11940-014-0310-9

- Moritz M L, Ayus J C. Hyponatraemia. Isotonic fluids prevent hospital-acquired hyponatraemia. Nature Reviews Nephrology [Internet]. 2015 April [cited March 3 2017]; 11: [Above 2p.]. Available from: http://www.nature.com/nrneph/journal/v11/n4/pdf/nrneph.2014.253.pdf

- McNab S, Duke T, South M, Babl F E, Lee K J, Arnup S J et al. 140 mmol/l of sodium versus 77 mmol/l of sodium in maintenance intravenous fluid therapy for children in hospital (PIMS): a randomised controlled double-blind trial. Lancet [Internet]. 2014 Nov [cited March 3 2017]; 385(9974): [Above 8p.]. Available from: http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2814%2961459-8.pdf

- Toledo J D, Morell C, Vento M. Intravenous isotonic fluids induced a positive trend in natraemia in children admitted to a general pediatric ward. Acta Pediatrica [Internet]. 2016 [cited March 7 2017]; 105(6): [aprox.6p.]. Available from: http://onlinelibrary.wiley.com/doi/10.1111/apa.13316/full

- Rey C, Los-Arcos M, Hernández A, Sánchez A, Díaz J J, López-Herce J. Hypotonic versus isotonic maintenance fluids in critically ill children: a multicenter prospective randomized study. Acta Pediatrica [Internet]. 2011 Mar [cited March 7 2017]; 100(8): [Above 6p.]. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1651-2227.2011.02209.x/full

- Lee J M, Jung Y, Lee S E, Lee J H, Kim K H, Koo J W et al. Intravenous fluid prescription practices among pediatric residents in Korea. Korean Journal of Pediatrics [Internet]. 2013 Jul [cited March 7 2017]; 56(7): [Above 4p.]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3728446/pdf/kjped-56-282.pdf

- Mc Nab S. Intravenous maintenance fluid therapy in children. Journal of Paediatrics and Child Health [Internet]. 2016 Apr [cited March 7 2017]; 52(2): [Above 4p]. Available from: http://onlinelibrary.wiley.com/doi/10.1111/jpc.13076/pdf

- Wang J, Xu E, Xiao Y. Isotonic Versus Hypotonic Maintenance IV Fluids in

Hospitalized Children: A Meta-Analysis. PEDIATRICS [Internet]. 2014 Jan [cited March 7 2017]; 133(1): [Above 11p.]. Available from: http://pediatrics.aappublications.org/content/pediatrics/133/1/105.full.pdf

- Shukla S, Basu S, Moritz M L. Use of Hypotonic Maintenance Intravenous Fluids and Hospital-Acquired Hyponatremia Remain Common in Children Admitted to a General Pediatric Ward. Front Pediatr [Internet]. 2016 Aug [cited March 8 2017]; 4 :90. [Above 5p.]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996996/pdf/fped-04-00090.pdf

- Narsaria P, Lodha R. Isn’t it Time to Stop Using 0.18% Saline in Dextrose Solutions for Intravenous Maintenance Fluid Therapy in Children? Indian Pediatrics [Internet]. 2014 Dic [cited March 7 2017]; 51(12): [Above 3p.]. Available from: http://www.indianpediatrics.net/dec2014/964.pdf

- Friedman J N, Beck CE, De Groot J, Geary D F, Sklansky DJ, Freedman S B. Comparison of Isotonic and Hypotonic Intravenous Maintenance Fluids. A Randomized Clinical Trial. JAMA Pediatr [Internet]. 2015 [cited March 5 2017]; 169(5): [Above 7p.]. Available from:

http://jamanetwork.com/pdfaccess.ashx?url=/data/journals/peds/933858/poi140102.pdf&routename=jamapediatrics

- Freeman M A, Ayus J C, Moritz M L. Maintenance Intravenous Fluid Prescribing Practices Among Pediatric Residents. Acta Pediatrica [Internet]. 2012 [cited March 8 2017]; 101(10): [Above10 p.]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4042841/pdf/nihms-586463.pdf

- Moritz M L, Ayus J C. New aspects in the pathogenesis, prevention, and treatment of hyponatremic encephalopathy in children. Pediatric Nephrology (Berlin, Germany) [Internet]. 2010 [cited March 8 2017]; 25(7): [Above14p.]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874061/pdf/467_2009_Article_1323.pdf

-Choong K, McNab S. IV fluid choices in children: have we found the solution? J Pediatr [Internet]. 2015; 91(5): [Above 3p.]. Available from: http://ac.els-cdn.com/S2255553615000920/1-s2.0-S2255553615000920-main.pdf?_tid=74330dd8-0048-11e7-91e3-00000aacb35f&acdnat=1488569864_9684248356f9d980ad43caeca26ef3df

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