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Published on: January 17, 2011
[Perioperative fluid guideline in preterms, newborns, toddlers and infants]
Jochen M Strauss1, Robert Sümpelmann
1Klinik für Anästhesie, perioperative Medizin und Schmerztherapie am HELIOS Klinikum Berlin Buch, Germany. jochen.strauss@helios-kliniken.de
Insights
Perioperative fluid therapy aims to correct pre-existing deficits and intraoperative losses. Glucose infusion is vital for premature infants at risk of hypoglycemia, with electrolyte solutions ensuring stability.
Area of Science:
- Anesthesiology
- Pediatric Critical Care
- Fluid and Electrolyte Management
Context:
- Perioperative care involves managing fluid balance to optimize patient outcomes.
- Infants and children present unique challenges in fluid therapy due to metabolic and physiological differences.
Purpose:
- To outline the principles of perioperative fluid therapy.
- To detail specific fluid and glucose requirements for pediatric patients, especially those at risk of hypoglycemia.
- To emphasize the importance of monitoring fluid therapy efficacy.
Summary:
- Perioperative fluid therapy addresses preoperative deficits, maintenance needs, and intraoperative losses of water, electrolytes, and blood components.
- Glucose-containing electrolyte solutions are recommended for premature infants and children at risk of hypoglycemia.
- Circulatory stabilization can be achieved with glucose-free solutions or artificial colloids for larger volume needs.
- Effective fluid and volume therapy requires adapted circulation monitoring and regular blood gas analysis, particularly during major procedures.
Impact:
- Ensures appropriate fluid management strategies are implemented in perioperative settings.
- Improves metabolic stability and reduces complications in vulnerable pediatric populations.
- Highlights the critical role of monitoring in optimizing fluid therapy outcomes.
Abstract:
The purposes of perioperative fluid therapy are to balance deficits that have occurred preoperatively, to realize the continuous infusion of maintenance requirements referred to body weight an to effect a correction of the intraoperative losses of water, electrolytes and blood components. Premature and new-born infants as well as children at risk for hypoglycaemia should additionally receive glucose in order to stabilise the glucose concentration and metabolism. Full electrolyte solutions containing 1 % glucose are sufficient. In cases with larger volume requirements, the circulatory system can be stabilized by the additional infusion of a glucose-free full electrolyte solution. Also in the cases of small children, artificial colloids may also be administered additionally. The efficacy of fluid and volume therapy should be controlled by an appropriately adapted circulation monitoring and regular blood gas analyses, especially for major interventions.
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