A randomized controlled trial of isotonic versus hypotonic maintenance intravenous fluids in hospitalized children

<p>Abstract</p> <p>Background</p> <p>Isotonic saline has been proposed as a safer alternative to traditional hypotonic solutions for intravenous (IV) maintenance fluids to prevent hyponatremia. However, the optimal tonicity of maintenance intravenous fluids in hospitalized children has not been determined. The objective of this study was to estimate and compare the rates of change in serum sodium ([Na]) for patients administered either hypotonic or isotonic IV fluids for maintenance needs.</p> <p>Methods</p> <p>This was a masked controlled trial. Randomization was stratified by admission type: medical patients and post-operative surgical patients, aged 3 months to 18 years, who required IV fluids for at least 8 hours. Patients were randomized to receive either 0.45% or 0.9% saline in 5.0% dextrose. Treating physicians used the study fluid for maintenance; infusion rate and the use of additional fluids were left to their discretion.</p> <p>Results</p> <p>Sixteen children were randomized to 0.9% saline and 21 to 0.45% saline. Baseline characteristics, duration (average of 12 hours) and rate of study fluid infusion, and the volume of additional isotonic fluids given were similar for the two groups. [Na] increased significantly in the 0.9% group (+0.20 mmol/L/h [IQR +0.03, +0.4]; P = 0.02) and increased, but not significantly, in the 0.45% group (+0.08 mmol/L/h [IQR -0.15, +0.16]; P = 0.07). The rate of change and absolute change in serum [Na] did not differ significantly between groups.</p> <p>Conclusions</p> <p>When administered at the appropriate maintenance rate and accompanied by adequate volume expansion with isotonic fluids, 0.45% saline did not result in a drop in serum sodium during the first 12 hours of fluid therapy in children without severe baseline hyponatremia. Confirmation in a larger study is strongly recommended.</p> <p>Clinical Trial Registration Number</p> <p><a href="http://www.clinicaltrials.gov/ct2/show/NCT00457873">NCT00457873</a> (<url>http://www.clinicaltrials.gov/</url>)</p

The effect of ice type on ice adhesion

To lower the ice adhesion strength is the most efficient technique for passive ice removal for several applications. In this paper, the effect of different types of ice on the ice adhesion strength was investigated. The ice types precipitation ice, in-cloud ice and bulk water ice on the same aluminum substrate and under similar environmental conditions were investigated. The ice adhesion strength was measured with a centrifugal adhesion test and varied from 0.78 ± 0.10 MPa for precipitation ice, 0.53 ± 0.12 MPa for in-cloud ice to 0.28 ± 0.08 MPa for bulk water ice. The results indicate that the ice adhesion strength inversely correlates with the density of ice. The results inspire a new strategy in icephobic surface development, specifically tailored to the relevant ice type

Presentations of computably enumerable reals

Abstract We study the relationship between a computably enumerable real and its presentations: ways of approximating the real by enumerating a prefix-free set of binary strings

Completing pseudojump operators

We investigate operators which take a set X to a set relatively computably enumerable in and above X by studying which such sets X can be so mapped into the Turing degree of K. We introduce notions of nontriviality for such operators, and use these to study which additional properties can be required of sets which can be completed to the jump by given c.e. operators.

Randomness and reducibility

How random is a real? Given two reals, which is more random? If we partition reals into equivalence classes of reals of the “same degrees of randomness”, what does the resulting structure look like? The goal of this paper is to look at questions like these, specifically by studying the properties of reducibilities that act a