Abstract
BACKGROUND: This study aimed to evaluate the differential effects of normal saline (N/S) (0.9% sodium chloride) and half saline (H/S) (0.45% sodium chloride) preservation solutions on sodium levels, blood pressure, and acid-base balance in critically ill pediatric patients. METHODS: A double-blind interventional clinical trial involving 88 pediatric patients was conducted in the pediatric intensive care unit. Patients were randomly assigned to receive either N/S (Group A) or H/S (Group B). Sodium, potassium, chloride, bicarbonate, pH, and blood pressure were measured at baseline and 6, 24, 48, and 72 hours. The primary outcome was the change in serum sodium concentration, and secondary outcomes included blood pressure and acid-base status. RESULTS: At 72 hours, sodium levels were significantly higher in the N/S group (137.63 ± 2.99 mEq/L) compared to the H/S group (135.33 ± 2.46 mEq/L; P = .007). Blood pressure was significantly higher in the N/S group at 24 hours (98.78 ± 8.08 mm Hg vs 92.70 ± 9.24 mm Hg; P = .002). No significant differences were observed in potassium levels, pH, or bicarbonate concentrations. The incidence of hyponatremia at 72 hours was similar in both the groups (15.9% for N/S vs 13.6% for H/S). CONCLUSION: Normal saline administration resulted in higher sodium levels and increased systolic blood pressure than H/S administration. These findings underscore the importance of tailored fluid therapy in critically ill pediatric patients, highlighting the potential effects of fluid choice on sodium balance and hemodynamics.