Intravenous maintenance fluid therapy in children

Area of Science:

• Pediatric critical care medicine
• Clinical fluid therapy
• Pediatric hospital medicine

Background:

• Intravenous fluid administration is common in pediatrics.
• Current fluid practices are linked to adverse outcomes.
• Safe fluid administration requires understanding composition and rate, plus monitoring.

Purpose of the Study:

• To evaluate the impact of isotonic fluids on pediatric intravenous therapy.
• To determine if isotonic fluids reduce adverse events like hyponatraemia.
• To advocate for guideline changes regarding primary maintenance fluids in children.

Main Methods:

• Review of recent evidence on intravenous fluid composition in pediatric patients.
• Analysis of studies comparing isotonic fluids to other fluid types.
• Assessment of adverse outcomes, specifically hyponatraemia.

Main Results:

• Recent evidence supports the use of isotonic fluids with plasma-like sodium concentrations.
• Isotonic fluids were associated with a decreased risk of hyponatraemia.
• No increase in other adverse effects was observed with isotonic fluid use.

Conclusions:

• Isotonic fluids should be considered the primary maintenance intravenous fluid for most children.
• Guideline changes are warranted to reflect the benefits of isotonic fluid therapy.
• Optimizing fluid composition enhances patient safety in pediatric care.