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

State-of-the-art on power line de-icing

This paper presents a detailed review of the different de-icing techniques, already developed and in development, which could be applied to the conductors and wires of electric power lines. After a bibliographical search in various data banks, on de-icing processes, more than 30 techniques at different stages of development, capable of removing ice and assuring anti-icing protection, have been identified in different fields such as air and rail transport, electrical networks, telecommunications, etc. Although many techniques have not yet made it beyond the concept stage, some are used in several of the sectors previously mentioned. The following is a comparative evaluation of all these techniques, thermal, mechanical and passive, based on energy efficiency and practicability. It is recommended to favor the mechanical techniques over thermal methods that have been developed, but require more energy. Specific development projects and feasibility studies on the most attractive techniques have finally been identified as steps for progress in power line de-icing

Icephobic coating evaluation for aerospace applications

This paper presents an extended study on the properties of icephobic coatings for aerospace applications, more specifically rotorcraft. Ideally, an icephobic material should be the least expensive anti-icing solution, inasmuch as the anti-icing effect is not destroyed by inclement environmental conditions. Several studies on the subject have already been published. Nevertheless, in most cases, only the results of ice adhesion on freshly coated samples are presented and discussed. In this study, the effects of aging (weathering and erosion) and of the number of ice/deicing cycles on coating durability were also considered relative to their possible use on airplanes and helicopters. In the first step, ice adhesion was measured in Centrifuge Adhesion Tests (CAT) on eight promising coatings. The ice adhesion τadh of the candidate coatings was found to vary from 0.001 MPa to 0.16 MPa. In the second step, in order to analyze ice accretion and ice shedding, four favorable coatings were evaluated in a wind tunnel on scaled-down rotor (SRB) set-ups, which were iced and rotated until shedding occurred. Regarding the environmental aspect, the durability of the utmost ice adhesion reducer coatings was evaluated under rain and sand erosion, as well as multiple icing/deicing exposures