From
StayCurrentMD
Maintenance Fluids in Resuscitation: 2018 Pediatric Surgery Practice Gap #4
With Dr. Todd Ponsky
Part of
Hyponatremia 3 items
Chapter 1 of 1 · Evidence & Research
Maintenance fluids
Practice Gap #4: Isotonic vs Hypotonic Maintenance Fluids
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Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Traditional training involved starting with normal saline or LR and then switching to half normal saline or quarter normal saline
Despite available evidence, most practitioners are still reluctant to adopt isotonic maintenance fluids
Many practitioners still order hypotonic fluids on the floor
Traditional dogma was to switch from isotonic to hypotonic fluids once reaching maintenance phase
New recommendation is to continue with isotonic fluids during maintenance phase
Continuing isotonic fluids decreases the risk of hyponatremia without any adverse consequences
