Adverse effects of rapid isotonic saline infusion

Neville et al reported on a randomised controlled trial of hypotonic versus isotonic saline for rehydration of children with gastroenteritis. They found that isotonic saline was superior with regards to correction of hyponatraemia.1 The majority of patients in the study received a “rapid replacement protocol” which entailed the infusion of 40 ml/kg of isotonic saline over 4 hours in the isotonic saline arm of the study. The authors did not report on important known adverse effects associated with rapid infusion of isotonic …