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CompletedNCT06484608Updated Jul 3, 2024

Comparison of Isotonic Versus Hypotonic Fluids in Neonates for Maintenance Fluid Therapy After Surgery

An interventional study of Isotonic Saline with Dextrose in Hyponatremia, Hypernatremia and Postoperative Care in Neonates, sponsored by Rawalpindi Medical College. Completed at 1 site in Pakistan. Open to participants aged 1 Day to 30 Days, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-07-03.

Sponsored by Rawalpindi Medical College · Not applicable, Interventional, and Other

From the registry’s dates

  • Registered 1 year 5 months after the study started (first participant enrolled Jan 2023, registered Jun 2024).
Phase
Not applicable
Study type
Interventional
Enrollment
84
Allocation
Randomized
Ages
1 Day to 30 Days
Sex
All
01

Study summary

The goal of this clinical trial is to determine if isotonic or hypotonic fluids are more effective in maintaining serum sodium levels in neonates undergoing maintenance fluid therapy post-surgery. The main questions it aims to answer are:

Does isotonic fluid therapy reduce the risk of hyponatremia compared to hypotonic fluid therapy? Does hypotonic fluid therapy lead to fewer cases of hypernatremia compared to isotonic fluid therapy? Researchers will compare neonates receiving isotonic fluids (Group I: isotonic/normal saline with 5% dextrose in 0.9% saline) to those receiving hypotonic fluids (Group H: hypotonic saline with 5% dextrose in 0.45% saline) to see if there are significant differences in serum sodium levels and associated complications.

Participants will:

Be randomly assigned to receive either isotonic or hypotonic fluids. Have blood samples taken before and after surgery to assess serum sodium levels.

Be monitored for 24 hours post-surgery to observe any complications such as hyponatremia, hypernatremia, or edema.

This study enrolled 84 neonates admitted to the neonatal intensive care unit following surgery, and data analysis was conducted using SPSS software version 25.0.

Read the detailed description

The primary objective of this clinical trial is to determine the most appropriate type of maintenance fluid (isotonic versus hypotonic) for neonates following surgery. The study enrolled 84 neonates, aged 1-28 days, who were admitted to the neonatal intensive care unit at Holy Family Hospital Rawalpindi from January 2023 to December 2023.

Neonates were randomly assigned into two groups:

Group I: Received isotonic/normal saline with 5% dextrose in 0.9% saline. Group H: Received hypotonic saline with 5% dextrose in 0.45% saline. Blood samples were collected before surgery and 24 hours post-surgery to measure serum sodium levels. The main outcome measures were the incidence of hyponatremia (serum sodium level \<135 mEq/L) and hypernatremia (serum sodium level >145 mEq/L). Secondary outcomes included other complications such as edema.

The results indicated that:

Hyponatremia occurred in 2 (4.8%) cases in the isotonic group and 11 (26.2%) cases in the hypotonic group.

Hypernatremia was observed in 9 (21.4%) cases in the isotonic group and none in the hypotonic group.

Edema was noted in 1 (2.4%) neonate in the isotonic group and 9 (21.4%) neonates in the hypotonic group.

The study concluded that isotonic saline is more effective in maintaining normal serum sodium levels and reducing the risk of hyponatremia and other complications compared to hypotonic saline in neonates post-surgery. Further research with larger sample sizes and additional electrolyte considerations is recommended to improve outcomes and reduce morbidity and mortality in this population.

02

Conditions studied

  • Hyponatremia
  • Hypernatremia
  • Postoperative Care in Neonates
  • Edema

Keywords

  • isotonic saline, hypotonic saline, neonates, maintenance fluid therapy, surgery, hyponatremia
03

In context

Hyponatremia

164 studies on the registry are indexed under Hyponatremia; 16 are open to participants now.

This study's enrollment of 84 is above the median of 60 across 98 interventional studies indexed under Hyponatremia.

Browse Hyponatremia studies →

Lead sponsor

Rawalpindi Medical College is the lead sponsor of 24 studies on the registry; 6 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
1 Day to 30 Days
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Neonates aged 1-28 days. Admitted to the neonatal intensive care unit (NICU) at Holy Family Hospital Rawalpindi.

Scheduled for surgery requiring maintenance fluid therapy postoperatively. Parental or guardian consent obtained.

Exclusion criteria

Exclusion Criteria:

  • Neonates with pre-existing electrolyte imbalances or metabolic disorders. Neonates with congenital heart disease or renal impairment. Neonates on diuretics or other medications affecting fluid balance. Neonates with a history of intrauterine growth restriction (IUGR). Neonates with major congenital anomalies. Lack of parental or guardian consent.
05

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
84 participants (actual)

Study arms

  • Experimental
    Isotonic Fluid Group

    Neonates in this group will receive isotonic/normal saline with 5% dextrose in 0.9% saline as their maintenance fluid therapy post-surgery. This intervention aims to maintain serum sodium levels and reduce the risk of hyponatremia and other complications.

    Drug: Isotonic Saline with Dextrose

  • Active comparator
    Hypotonic Fluid Group

    Neonates in this group will receive hypotonic saline with 5% dextrose in 0.45% saline as their maintenance fluid therapy post-surgery. This intervention is being compared to isotonic fluid therapy to evaluate its effectiveness and safety in maintaining electrolyte balance and preventing hypernatremia and edema.

    Drug: Isotonic Saline with Dextrose

Interventions

  • DrugIsotonic Saline with Dextrose

    This clinical trial involves two interventions for maintaining fluid therapy in neonates post-surgery. The first intervention, isotonic saline with dextrose, involves administering 0.9% saline solution combined with 5% dextrose. This isotonic solution aims to maintain serum sodium levels within the normal range and minimize the risk of hyponatremia and hypernatremia in postoperative neonates. The second intervention, hypotonic saline with dextrose, involves administering 0.45% saline solution combined with 5% dextrose. This hypotonic solution is being compared to the isotonic solution to evaluate its effectiveness in maintaining electrolyte balance.

    Also known as: Hypotonic Saline with Dextrose

06

What researchers measure

Primary outcomes

  1. Incidence of Hyponatremia and Hypernatremia

    This outcome measures the incidence of hyponatremia (serum sodium level \<135 mEq/L) and hypernatremia (serum sodium level \>145 mEq/L) in neonates receiving either isotonic or hypotonic saline with dextrose as maintenance fluid therapy post-surgery

    Time frame: Before surgery (baseline measurement) 24 hours post-surgery

Secondary outcomes

  1. Incidence of Edema

    This outcome measures the incidence of edema in neonates receiving either isotonic or hypotonic saline with dextrose as maintenance fluid therapy post-surgery

    Time frame: Before surgery (baseline measurement) 24 hours post-surgery

07

Study locations

1 site
  • Mehak Fatima
    Rawalpindi, Punjab 00042, Pakistan
08

References and documents

Individual participant data

Plan to share: No — The plan for sharing individual participant data (IPD) is currently undecided. We recognize the importance of data sharing to advance scientific knowledge and improve clinical practices. We are considering several factors, including patient privacy, ethical considerations, and the logistics of data management, to make an informed decision. If a decision to share data is made in the future, we will outline the conditions under which the data will be shared, the type of data to be shared, and the means by which interested researchers can access the data. Any IPD sharing will be conducted in accordance with applicable regulations and ethical guidelines to ensure the protection of participant confidentiality and data integrity.

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Jan 2023 to primary completion in Dec 2023, 11 months.

Of 24 interventional studies with no phase under Hyponatremia, half reached primary completion within 24 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 48. This study's 11 months is below that.

How these figures are worked out, and which studies are left out of them.

Registered
Jun 26, 2024
First posted
Jul 3, 2024
StartActual
Jan 1, 2023
Primary completionActual
Dec 29, 2023
CompletionActual
Dec 29, 2023
Last update
Jul 3, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 3, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06484608
Lead sponsor
Rawalpindi Medical College
Responsible party
Mehak Fatima (Mehak Fatima, Rawalpindi Medical College) — Principal investigator
First posted
Jul 3, 2024
Start date
Jan 1, 2023
Primary completion
Dec 29, 2023
Completion
Dec 29, 2023
Last update
Jul 3, 2024

Study contacts

Mehak Fatima, MBBS
principal investigator · RMU

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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