Every day in hospitals around the world, children are given an intravenous (IV) fluid to help maintain their hydration – a fluid which has been the same since the 1950s.
But a landmark study published in The Lancet recommended hospitals change the fluid, as it may be impacting the sodium levels in childrens’ blood.
In recent years, doctors were concerned children on IV drips were at higher risk of developing a condition which could lead to serious side effects, including brain swelling and even death.
Lead researcher Dr Sarah McNab said the study found that increasing the sodium concentration in IV fluid kept the sodium level in the blood more stable, which in turn prevented these side effects.
The study, conducted by the Murdoch Children’s Research Institute and the Royal Children’s Hospital, was one of the largest and most diverse studies of its kind.
“The study that we’ve conducted involved 690 children at the Royal Children’s Hospital in Melbourne,” Dr McNab said.
“They were all children who needed intravenous fluid, or fluid through a drip, so they were children who couldn’t eat or drink enough to keep their hydration levels up.”
“We gave half of the children one type of fluid – the fluid that we’ve traditionally used for many years – and we gave the other half [fluid] that contained more sodium, or more salt.
“What we found, was that in increasing the sodium concentration in the fluid, we could keep the sodium level in the blood more stable, which we think will prevent some very serious side effects.”
Dr McNab said hospitals had been administering traditional IV solutions to children for decades.
“A study back in the 1950s recommended a low sodium containing fluid, so we’ve been using a fluid like that, or a variation on that fluid, ever since,” she said.
“A bit over a decade ago, there was increasing reports of people being very concerned about this type of fluid.
“What was being reported in the medical literature was that children were dying around the world simply because of the intravenous fluid, or IV fluid, that we were giving them.
“That really concerned us, but the problem was there was no research to tell us if there was a safer fluid, or a better fluid that we could use.”
Brain swelling, seizures and death linked in traditional IV drips
Dr McNab said there are a number of dangerous side effects reported when rehydrating children with traditional IV fluid.
“By using the traditional fluid, the sodium level in the blood can drop … and in very rare cases that can lead to brain swelling and even death,” she said.
“Sometimes they’ll cause seizures, sometimes they’ll cause bad brain effects, but absolutely, at the most extreme level, they’re fatal.”
Dr McNab said while there had only been 50 reported cases of the serious side effects in children, her research should change the management of hospitalised children around the world.
“We think that a simple change to the composition of intravenous fluid in children around the world should be able to save many lives.”
Dr McNab said it would be an easy switch for hospitals to change the IV solution to a new isotonic formula.
“Practically, it shouldn’t be hard at all. Both fluids are made by fluid manufacturers around the world, so we think that that should be a pretty straightforward undertaking,” she said.
“Of course, translating research into practice is always a challenge for researchers and doctors, but we’re very hopeful that given the exposure this study’s been given, by being published in The Lancet …we should be able to reach many, many doctors treating children around the world, and hopefully they will change what they do.”