The Journal of Pediatrics
Volume 154, Issue 6 , Pages 895-900, June 2009

Sodium Concentration in Rehydration Fluids for Children with Ketoacidotic Diabetes: Effect on Serum Sodium Concentration

  • Juan Diego Toledo, MD

      Affiliations

    • Pediatric Intensive Care Unit, Children's Hospital La Fe, Valencia, Spain
    • ,
  • Vicente Modesto, MD

      Affiliations

    • Pediatric Intensive Care Unit, Children's Hospital La Fe, Valencia, Spain
    • ,
  • Magdalena Peinador, MD

      Affiliations

    • Department of Pediatrics, Children's Hospital La Fe, Valencia, Spain
    • ,
  • Pablo Álvarez, MD

      Affiliations

    • Pediatric Intensive Care Unit, Children's Hospital La Fe, Valencia, Spain
    • ,
  • José Luis López-Prats, MD

      Affiliations

    • Pediatric Intensive Care Unit, Children's Hospital La Fe, Valencia, Spain
    • ,
  • Ramón Sanchis, MD

      Affiliations

    • Pediatric Intensive Care Unit, Children's Hospital La Fe, Valencia, Spain
    • ,
  • Máximo Vento, MD, PhD

      Affiliations

    • Neonatal Research Unit, Division of Neonatology, Children's Hospital La Fe, Valencia, Spain
    • Corresponding Author InformationReprint requests: Máximo Vento, PhD, MD, Neonatal Research Unit, Division of Neonatology, Children's Hospital La Fe, Avenida de Campanar, 21, E46009 Valencia, Spain

Received 1 September 2008; received in revised form 14 November 2008; accepted 23 December 2008. published online 23 February 2009.

Objectives

To analyze in a retrospective cohort if sodium concentration in the rehydration fluids influence natremia in children with diabetic ketoacidosis (DKA).

Study design

Consecutive episodes of diabetic ketoacidosis admitted in a tertiary care referral center from 2000 to 2005. Rehydration was programmed for 48 hours with a 2-bag system. Initial rehydration was performed with isotonic fluids and thereafter with variable tonicity. Analysis of the influence of the different factors on natremia was performed with a multivariate linear regression analysis.

Results

Forty-two episodes of DKA were reviewed. Increased sodium content in rehydration fluids behaved as an independent variable, causing a positive tendency of natremia (P < .008).

Conclusions

Sodium concentration in the rehydration fluids behaves as an independent factor that influences positively the trend of the serum concentration of sodium during DKA rehydration. We propose the use of isotonic solutions for rehydration in diabetic ketoacidosis.

Abbreviations: DKA, Diabetic ketoacidosis, PICU, Pediatric intensive care unit

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 The authors declare no conflicts of interest.

PII: S0022-3476(08)01146-3

doi:10.1016/j.jpeds.2008.12.042

The Journal of Pediatrics
Volume 154, Issue 6 , Pages 895-900, June 2009

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