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[Reappraisal of perioperative fluid therapy in children]

Yugo Okabe1, Nobuhiro Maekawa

  • 1Department of Anesthesia, Faculty of Medicine, Kagawa University Kagawa 761-0793.

Masui. the Japanese Journal of Anesthesiology
|May 23, 2007
PubMed

Insights

Hospital-acquired hyponatremia in children is a concern. Reducing intravenous fluid volumes and adding glucose to maintenance fluids may mitigate risks during the perioperative period.

Area of Science:

  • Pediatric Medicine
  • Intravenous Fluid Therapy
  • Hyponatremia Management

Background:

  • Hospital-acquired hyponatremia is a recognized risk in children receiving intravenous hypotonic fluids.
  • Perioperative pediatric patients face risks of antidiuretic hormone (ADH) secretion and insulin resistance.

Purpose of the Study:

  • To review hospital-acquired hyponatremia in children treated with intravenous hypotonic maintenance fluids.
  • To discuss the advantages and disadvantages of adding glucose to intravenous fluids for pediatric patients.

Main Methods:

  • Literature review of hyponatremia in pediatric perioperative care.
  • Analysis of fluid composition and glucose supplementation strategies.

Main Results:

  • Reduced intravenous fluid volumes (by 50%) and approximately 2% glucose concentration are suggested for perioperative pediatric patients.
  • Controversy remains regarding the optimal fluid choice (isotonic vs. hypotonic) for postoperative maintenance, with weak evidence supporting either.

Conclusions:

  • Adjusted fluid volumes and glucose concentrations are recommended to manage perioperative risks.
  • Further research is necessary to determine the best fluid composition for postoperative maintenance in children.

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