Problems associated with intravenous fluid administration in children: do we have the right solutions?

Edema, both in its cellular and tissue form, is a frequent complication in critically ill patients. In health, a balance is struck between intracellular and extracellular osmotic forces and interstitial and intravascular oncotic forces, which in turn governs fluid distribution between the intracellular, extracellular and interstitial fluid compartments. The use of hypo- and hypernotic electrolyte solutions has major effects on brain cells, which can be detrimental or beneficial. The controversy over the use of colloids versus crystalloid solutions in critically ill patients remains unresolved.