Effect of Saline versus Gluconate/Acetate-Buffered Solution versus Lactate-Buffered Solution on Serum Chloride Among Children.

BACKGROUND

Intravenous (IV) fluid administration is routine in pediatric care, but fluid composition can significantly influence serum electrolyte levels. Hyperchloremia, often associated with 0.9% saline, may lead to metabolic acidosis and renal dysfunction. Balanced solutions, including gluconate/acetate-buffered and lactate-buffered fluids, are being explored for safer alternatives.

OBJECTIVE

To compare the effects of saline, gluconate/acetate-buffered, and lactate-buffered IV fluids on serum chloride levels in hospitalized children.

MATERIALS AND

METHODS

A prospective observational study was conducted among pediatric in patients receiving one of three IV fluids: saline (n = 30), gluconate/acetate-buffered solution (n = 30), or lactate-buffered solution (n = 30). Serum chloride was measured at baseline and after 24 h of fluid administration. Statistical analysis was performed using ANOVA and paired t-tests.

RESULTS

Mean post-infusion chloride levels were significantly higher in the saline group (107.2 ± 3.1 mmol/L) compared to the gluconate/acetate group (103.5 ± 2.4 mmol/L) and lactate-buffered group (102.9 ± 2.8 mmol/L) (P < 0.001). Chloride elevation was most pronounced in the saline group, with associated trends toward mild acidosis.

CONCLUSION

Saline use in children is associated with greater increases in serum chloride compared to balanced solutions. Buffered fluids may be preferable for maintaining electrolyte stability in pediatric fluid therapy.