BACKGROUND Hypotonic fluids have been associated with hospital-acquired hyponatremia. The incidence of life-threatening severe hyponatremia associated with hypotonic fluids has not been evaluated. METHODS This was a population-based cohort study of 46,518 acutely ill children 15 years of age or under who visited the pediatric emergency department (ED) at Oulu University Hospital, Finland, between 2007 and 2017. We retrieved all electrolyte measurements from the comprehensive electronic laboratory system and reviewed medical records for all patients with severe hyponatremia. RESULTS The overall occurrence of severe hyponatremia (serum sodium < 125 mmol/L) was found in 27 out of 46,518 acutely ill children (0.06%, 95% confidence interval 0.04-0.08%). After admission, severe hyponatremia developed in seven of 6,984 children receiving moderately hypotonic fluid therapy (0.1%, 95% confidence interval 0.04-0.2%), usually within 8 h of admission. All children who developed severe hyponatremia during hospitalization were severely ill. CONCLUSION In this register-based cohort study of children presenting to the ED, severe hyponatremia developed in one of 998 acutely ill children receiving moderately hypotonic fluid therapy. A higher resolution version of the Graphical abstract is available as Supplementary information.

中文翻译：

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接受中度低渗液体的急性病儿童的严重医院获得性低钠血症。

背景技术低渗液体与医院获得性低钠血症有关。尚未评估与低渗液体相关的危及生命的严重低钠血症的发生率。方实验室系统并审查了所有严重低钠血症患者的医疗记录。结果 46,518 名急性病儿童中有 27 名发生严重低钠血症（血清钠 < 125 mmol/L）（0.06%，95% 置信区间 0.04-0.08%）。入院后，6 人中有 7 人出现严重的低钠血症，984 名儿童接受中度低渗液体治疗（0.1%，95% 置信区间 0.04-0.2%），通常在入院后 8 小时内。所有在住院期间出现严重低钠血症的儿童均病情严重。结论 在这项以登记为基础的对就诊于 ED 的儿童的队列研究中，998 名接受中度低渗液体治疗的急性病儿童中有一名出现了严重的低钠血症。图形摘要的更高分辨率版本可作为补充信息。在接受中度低渗液体治疗的 998 名急性病儿童中，有 1 名出现了严重的低钠血症。图形摘要的更高分辨率版本可作为补充信息。在接受中度低渗液体治疗的 998 名急性病儿童中，有 1 名出现了严重的低钠血症。图形摘要的更高分辨率版本可作为补充信息。