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Letters to the Editor: Letters & Announcements

Pediatric Postoperative Fluid Therapy

Avoiding Hyponatremia

Roth, Jonathan V., MD

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doi: 10.1213/ANE.0b013e3181f707ff
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To the Editor

In their discussion of crystalloid fluid therapy, neither Moritz and Ayus1 nor Bailey et al.2 mention using isotonic solutions such as Plasma-Lyte 148 (Baxter, Deerfield, IL) or Normosol-R (Hospira, Inc., Lake Forest, IL). We have found them very useful in the adult population, particularly in cases requiring a large volume of IV fluid. They do not cause a dilutional acidosis (as may occur with 0.9% NaCl), the serum sodium concentration tends to remain stable, they are compatible with blood administration, and they are isotonic (osmolality 294 mOsm/L) with a sodium concentration of 140 mEq/L. It would seem that either of these fluids may avoid the problems of pediatric perioperative hyponatremia and dilutional acidosis and may have additional benefit. Have these solutions been studied in the pediatric population?

Jonathan V. Roth, MD

Albert Einstein Medical Center

Philadelphia, Pennsylvania


1. Moritz ML, Ayus JC. Water water everywhere: standardizing postoperative fluid therapy with 0.9% normal saline. Anesth Analg 2010;110:293–5
2. Bailey AG, McNaull PP, Jooste E, Tuchman JB. Perioperative crystalloid and colloid management in children: where are we and how did we get here? Anesth Analg 2010;110:375–90
© 2011 International Anesthesia Research Society