Comparing the prevalence of dysnatremia in 2 methods of IV maintenance fluid therapy with half saline versus standard 0.2 saline solutions in term neonates with sepsis

Objective: Comparing the prevalence of dysnatremia in two methods of intravenous maintenance fluid therapy with half saline (75 mEq/L) versus 0.2 saline (30mEq/L) solutions in term neonates with sepsis.Methods: In a double-blinded randomized clinical trial, Sixty term neonates (38-42 weeks of gestation) with sepsis were enrolled. Blood samples were taken with the aim of determining serum creatinine level, BUN, Na and K before the onset of treatment. Urine samples were taken to assess specific gravity and urinary output. Based on computerized random numerical table, the patients will be divided into two groups A and B. Group A, assigned to receive half-saline solution as maintenance intravenous fluid, and group B, assigned to receive the conventional 0.2 saline solution as maintenance. The above indicators were re-evaluated at 6, 24, and 48 hours after the initiation of treatment. The two groups were compared in respect to the incidence of dysnatremia, and other criteria such as urinary output and urinary specific gravity, BUN and Creatinine levels.Results:No patient developed hyponatremia or hypernatremia after 48 hours of therapy. Sodium levels were significantly higher in half saline recipients 24 h (137.83 ± 2.9 vs 134.4 ± 1.92 mmol/L), and 48h (137.67 ± 1.99 vs 133.1 ± 2.41 mmol/L) after treatment (P<0.001). The urinary output, urine specific gravity, K, BUN and Creatinine levels were not significantly different in two groups.Conclusions:The use of Half-Saline solution (75 mEq/L) as maintenance fluid did not increase the risk of hypernatremia after 48 hours when compared to 0.2 Saline solution, which is by now the conventional maintenance solution in neonates. Both half saline (Na 75 mEq/L or 0.45% NaCl) and Na 30 mEq/L NaCl or 0.2% solution can be used safely in term neonates.