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Intravenous fluid therapy for hospitalized and critically ill children: rationale, available drugs and possible side

Thomas Langer1, Rosamaria Limuti, Concezione Tommasino

  • 1Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy. thomas.langer@unimi.it.

Anaesthesiology Intensive Therapy
|November 19, 2017
PubMed

Insights

Children are prone to fluid and electrolyte imbalances, making parenteral fluid therapy critical. This review covers fluid balance, risks, and current practices for intravenous fluids in pediatric patients.

Area of Science:

  • Pediatrics
  • Nephrology
  • Critical Care Medicine

Background:

  • Children have a higher percentage of body water than adults, increasing susceptibility to fluid and electrolyte imbalances.
  • Parenteral fluid therapy is essential for hospitalized children, particularly newborns and infants.
  • Intravenous fluids are potent drugs with specific indications, contraindications, and potential side effects.

Purpose of the Study:

  • To review the physiology and pathophysiology of water and electrolyte balance in children.
  • To highlight the prevalence of non-osmotic antidiuretic hormone release in critically ill children.
  • To discuss available crystalloids, their properties, and side effects in pediatric patients.

Main Methods:

  • Review of water and electrolyte balance physiology and pathophysiology.
  • Analysis of non-osmotic antidiuretic hormone release in pediatric populations.
  • Evaluation of crystalloid characteristics and side effects for pediatric use.
  • Examination of current clinical practices for parenteral fluid therapy in children.

Main Results:

  • Children are at significant risk for water and electrolyte disturbances.
  • Non-osmotic antidiuretic hormone release is common in hospitalized and critically ill children.
  • Crystalloids vary in tonicity, necessitating careful selection for pediatric patients.

Conclusions:

  • Understanding fluid and electrolyte balance is crucial for safe and effective parenteral fluid therapy in children.
  • Distinguishing between hypotonic and isotonic fluids is vital for preventing adverse events.
  • Current practices involve consensus on resuscitation/replacement fluids but ongoing debate on maintenance fluids.

Keywords:
acid-base equilibriumcrystalloidsintravenous fluidspaediatric anaesthesiapaediatric critical care

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