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[Correspondence] Isotonic fluid for intravenous hydration maintenance in children

We congratulate Sarah McNab and colleagues1 for their large study providing definitive evidence that the use of an isotonic intravenous fluid for hydration maintenance in paediatric patients protects against the development of hyponatraemia without an increase in the risk of adverse events. We agree that although the risk of hyponatraemia seems small, those patients at risk of hyponatraemia cannot be predicted2,3 and that therefore a fluid that protects against hyponatraemia should be chosen. We were nevertheless surprised that by contrast with previous studies, including ours,2,4 no difference was identified in mean plasma sodium concentration at any timepoint in either group, despite the increasing risk of hyponatraemia with time in those receiving hypotonic saline.