Pediatric anesthesia & critical care
Postoperative free water administration is associated with dysnatremia after congenital heart disease surgery in infants
Authors' conclusion
Postoperative hyponatremia occurred in 30% of infants despite restrictive volumes of hypotonic maintenance fluid, whereas hypernatremia was mainly associated with blood product transfusion.
Study context
- Population
- Infants undergoing congenital heart disease (CHD) surgery
- Exposure
- Infants with vs without postoperative dysnatremia
- Outcome
- Fluid composition prior to and during development of postoperative dysnatremia
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Blood products, median [IQR]
50.5 [28.4-95.5] vs. 34.5 [18.5-61.1] mL/kg
P = 0.001
Hypernatremia
Free water load, median [IQR]
1.6 [1.1-2.2] mL/kg/h
P = 0.01
Hypernatremia · lower free water load
Free water load, median [IQR]
2.3 [1.7-3.3] vs. 1.8 [1.4-2.5] mL/kg/h
P = 0.001
Hyponatremia · also positive fluid balance
- Postoperative dysnatremia within 48 h after surgery
- nearly 50%
- Postoperative hyponatremia
- 30%
Observational data: associations, not effects.
Further findings
| Outcome | Free water, median [IQR] (mL/kg/h) | P value |
|---|---|---|
| Free water volume, postoperative day 1 (hyponatremia) | 2.0 [1.5-2.8] vs. 1.3 [1.1-1.8] | P < 0.001 |
Free water volume, postoperative day 1 (hyponatremia)
- Hyponatremia also associated with more human albumin, despite larger diuresis and more negative daily fluid balance
Original publication
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