Electrolyte disturbances and intravenous fluid therapy in acutely ill children

Acutely ill child needs intravenous maintenance fluid therapy, if sufficient amount of fluid and electrolytes can not be admit orally. To evaluate and treat fluidbalance is one of the main tasks in pediatric emergency department. In recent years, the use of commercial plasma-like intravenous fluid therapy has increased though there is a limited evidence of the use of plasma-like fluid therapy in acutely ill children.

In randomisez-controlled clinical trial of 614 acutely ill children, we observed that the use of commercial plasma-like intravenous fluid therapy caused a risk for low plasma potassium levels comparing to traditionally used intravenous fluid therapy. In addition, patients that received plasma-like intravenous fluid therapy had slightly more hypernatremia.

In large registerbased cohort study severe sodium abnormalities were associated to increase mortality, whereas mild sodium abnormalities were not.

The results of this thesis can be use to improve the use of intravenous fluid therapy in acutely ill children.