Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPRODRIGUES, Regina M.SCHVARTSMAN, Benita G. S.FARHAT, Sylvia C. L.SCHVARTSMAN, Claudio2014-04-282014-04-282014ACTA PAEDIATRICA, v.103, n.3, p.E111-E115, 20140803-5253https://observatorio.fm.usp.br/handle/OPI/5495AimTo investigate the influence of hypotonic parenteral hydration on serum and urinary sodium and osmolality in infants with moderate bronchiolitis. MethodsWe studied 36 infants (mean age 3.72.3months), with a diagnosis of moderate bronchiolitis admitted to a paediatric emergency unit in SAo Paulo, Brazil. Patients received a standard parenteral hypotonic solution, according to Holliday and Segar, during the first 24h, due to respiratory distress. The disease was monitored by a respiratory severity score (RDAI-Respiratory Distress Assessment Instrument), respiratory rate and oxygen saturation. Serum and urinary sodium and osmolality were monitored at admission, 24 and 48h after admission. ResultsAll respiratory parameters improved during hospitalisation. Serum sodium and osmolality dropped after 24h (136.8 +/- 2.8 and 135.8 +/- 2.6mEq/L, p=0.031; 283.4 +/- 4.1 and 281.6 +/- 3.9 mOsm/kg, p=0.004 respectively) as well as urinary osmolality (486.8 +/- 243.4 mOsm/kg and 355.7 +/- 205.0 mOsm/kg, p<0.001) when compared to admission. ConclusionThis study reinforces the occurrence of hyponatraemia in bronchiolitis even in patients with moderate disease and highlights the risk of serum sodium drop caused by hypotonic parenteral hydration.engrestrictedAccessHyponatraemiaHypotonic solutionModerate bronchiolitisPaediatricrespiratory syncytial virusplacebo-controlled trialhospitalized childrenantidiuretic-hormoneacute hyponatremiainfectionsecretionwatercomplicationsepinephrinearticleCopyright WILEY-BLACKWELL10.1111/apa.12493Pediatrics1651-2227