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Clinical Practice Guideline: Maintenance Intravenous Fluids in Children
- Source :
- Pediatrics. 142
- Publication Year :
- 2018
- Publisher :
- American Academy of Pediatrics (AAP), 2018.
-
Abstract
- Maintenance intravenous fluids (IVFs) are used to provide critical supportive care for children who are acutely ill. IVFs are required if sufficient fluids cannot be provided by using enteral administration for reasons such as gastrointestinal illness, respiratory compromise, neurologic impairment, a perioperative state, or being moribund from an acute or chronic illness. Despite the common use of maintenance IVFs, there is high variability in fluid prescribing practices and a lack of guidelines for fluid composition administration and electrolyte monitoring. The administration of hypotonic IVFs has been the standard in pediatrics. Concerns have been raised that this approach results in a high incidence of hyponatremia and that isotonic IVFs could prevent the development of hyponatremia. Our goal in this guideline is to provide an evidence-based approach for choosing the tonicity of maintenance IVFs in most patients from 28 days to 18 years of age who require maintenance IVFs. This guideline applies to children in surgical (postoperative) and medical acute-care settings, including critical care and the general inpatient ward. Patients with neurosurgical disorders, congenital or acquired cardiac disease, hepatic disease, cancer, renal dysfunction, diabetes insipidus, voluminous watery diarrhea, or severe burns; neonates who are younger than 28 days old or in the NICU; and adolescents older than 18 years old are excluded. We specifically address the tonicity of maintenance IVFs in children.The Key Action Statement of the subcommittee is as follows:1A: The American Academy of Pediatrics recommends that patients 28 days to 18 years of age requiring maintenance IVFs should receive isotonic solutions with appropriate potassium chloride and dextrose because they significantly decrease the risk of developing hyponatremia (evidence quality: A; recommendation strength: strong)
- Subjects :
- medicine.medical_specialty
Critical Care
Critical Illness
Hypovolemia
MEDLINE
Disease
Enteral administration
03 medical and health sciences
0302 clinical medicine
030225 pediatrics
medicine
Humans
030212 general & internal medicine
Child
Infusions, Intravenous
Intensive care medicine
business.industry
Incidence (epidemiology)
Perioperative
Guideline
medicine.disease
Practice Guidelines as Topic
Pediatrics, Perinatology and Child Health
Diabetes insipidus
Fluid Therapy
Isotonic Solutions
Hyponatremia
business
Subjects
Details
- ISSN :
- 10984275 and 00314005
- Volume :
- 142
- Database :
- OpenAIRE
- Journal :
- Pediatrics
- Accession number :
- edsair.doi.dedup.....8c089726229b6f3e92a4042b93560bb1
- Full Text :
- https://doi.org/10.1542/peds.2018-3083