Melbourne Paediatric Specialists

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Study recommends change of common IV fluids for children worldwide

Study recommends change of common IV fluids for children worldwide

New study recommends change of common IV fluids for children worldwide
– Lead researcher, Paediatrician and Melbourne Paediatric Specialist, Dr Sarah McNab spoke to Alison Caldwell, from ABC The World Today on December 1, 2014.

A new landmark study published in The Lancet in December 2014 is recommending hospitals change the fluid due to concerns about possible impacts on sodium levels in the blood.


Lead researcher and Paediatrician, Dr Sarah McNab spoke to Alison Caldwell, from the ABC’s The World Today. The audio of this report is available below.


The study by the Murdoch Childrens Research Institute and the Royal Children’s Hospital is one of the largest and most diverse studies of its kind.

The study showed that children who receive hypotonic IV fluid, which is currently routinely administered to maintain hydration, are at higher risk of developing hyponatremia (a low blood sodium level), which can lead to serious side effects, including death.

Researchers performed the largest and most diverse study of its kind in the world comparing hypotonic IV fluid with isotonic fluid which contains more sodium (77mmol/L vs 140mmol/L).

The study showed that children receiving the isotonic fluid had a lower risk of their blood sodium levels dropping, without an increase in other adverse effects.  The finding should completely change which IV fluid is given to children in hospital all around the world.

Lead researcher, Dr Sarah McNab, said the study should have widespread implications and could change the fluid that is given to all hospitalised children worldwide.

“In this study we have demonstrated that by changing the intravenous fluid we routinely use, we can reduce hyponatraemia – an abnormality that sometimes leads to serious side effects.”


“These findings were consistent across hospitalised children, medical and surgical patients. Based on these findings, widespread changes to intravenous fluid guidelines should be made.”

Study Abstract:

The Lancet

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

PIMS Paediatric Intravenous Maintenance Solution study: A double blind placebo controlled randomised controlled trial to determine whether an intravenous fluid with 140mmol/L of sodium is safer than our currently recommended fluid (77mmol/L of sodium) when used for maintenance hydration in paediatric patients. This is in response to ongoing concerns regarding hyponatraemic encephalopathy occurring in association with fluids containing low sodium concentrations.
(Dr Sarah McNab, A/Prof A Davidson, A/Prof Simon Young, A/Prof Franz Babl)

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