Published: 3 March 2016

Publications

Risk of Hyponatraemia with the use of Glucose 4% Sodium Chloride 0.18% Infusion Solution (‘Bart’s Solution’) in Children

This article is more than five years old. Some content may no longer be current.

Prescriber Update 37(1): 12
March 2016

Healthcare professionals are reminded that glucose 4% sodium chloride 0.18% infusion solution should not normally be used for fluid replacement in children because of the risk of hyponatraemia¹.

The availability of glucose 4% sodium chloride 0.18% infusion solution should be restricted to critical care and specialist wards such as renal, liver and cardiac units¹. It is important to consult a physician experienced in intravenous fluid therapy if low sodium fluids are required in children².

Infants and children may have an impaired ability to regulate fluid and electrolytes compared to adults. Fluid replacement therapy should be closely monitored in these populations as fluid and electrolyte disturbances such as hyponatraemia may occur².

Hyponatraemia can lead to headache, nausea, seizures, lethargy, coma and cerebral oedema². Prompt action must be taken if children (or adults) develop these signs and symptoms as fatalities have been reported.

References

1. New Zealand Formulary for Children. 2016. Parenteral preparations for fluid and electrolyte imbalance. NZFC v43. URL: www.nzfchildren.org.nz/nzf_5043 (accessed 13 January 2016).
2. Baxter Healthcare Ltd. 2015. Glucose and sodium chloride data sheet. 26 October 2015. URL: www.medsafe.govt.nz/profs/datasheet/GlucoseAndDextroseInSodiumChlorideinf.pdf (accessed 13 January 2016).