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Maintenance fluid practices in paediatric intensive care units in Australia and New Zealand
Shailesh Bihari1, Ben Gelbart2, Ian Seppelt3
1Department of ICCU, Flinders Medical Centre, Adelaide, SA, Australia. biharishailesh@gmail.com.
Insights
Maintenance fluid administration in paediatric intensive care units (PICUs) contributes about one-third of total fluid intake. This practice, primarily using isotonic solutions, has remained consistent over time in Australian and New Zealand PICUs.
Area of Science:
- Pediatric Intensive Care
- Fluid Management
- Clinical Practice Research
Background:
- Maintenance fluid administration is a standard practice in pediatric intensive care units (PICUs).
- Limited data exists regarding the specifics of this common practice.
- Understanding fluid administration is crucial for patient care and balance.
Purpose of the Study:
- To quantify the volume and type of maintenance fluids given to PICU patients.
- To evaluate any shifts in maintenance fluid practices compared to previous data.
- To inform best practices in pediatric fluid management.
Main Methods:
- A prospective, observational, point prevalence study was conducted across 11 Australian and New Zealand PICUs.
- Data was collected on a single day in 2014 from enrolled pediatric patients.
- Patient demographics and fluid administration details were recorded.
Main Results:
- Maintenance fluids were administered to 56% of infants and 50% of children over one year old.
- Infants received a median of 23 mL/kg and older children 18 mL/kg of maintenance fluid.
- Maintenance fluids constituted approximately 29-33% of total daily fluid intake, with no change from 2011 data.
Conclusions:
- Maintenance fluid represents a significant portion (about one-third) of total fluid administration in pediatric intensive care.
- Isotonic solutions are the predominant type of maintenance fluid used.
- Current maintenance fluid practices in Australian and New Zealand PICUs appear stable.
Background:
Maintenance fluid administration is a common practice in paediatric intensive care units (PICUs), contributing to daily fluid intake and fluid balance, but little is known about this practice.
Objectives:
To determine the volume and type of maintenance fluid delivered to PICU patients, and to assess changes in practice compared with a previous time point.
Methods:
A prospective, observational, single-day, point prevalence study of paediatric patients from 11 Australian and New Zealand PICUs, conducted in 2014.
Results:
Seventy-two patients were enrolled. The median age and weight of infants aged < 1 year (n = 34) were 2 months (interquartile range [IQR],1-4) and 5 kg (IQR, 4-6), respectively; while in children ≥ 1 year of age (n = 38), these were 4 years (IQR, 2-8) and 17 kg (IQR, 12-23), respectively. On the study day, 19 infants (56%) and 19 children aged ≥ 1 year (50%) received maintenance fluids. Infants received a median of 23 mL/kg (IQR, 12-45) of maintenance fluid in addition to 51 mL/kg (IQR, 40-72) of fluid and nutrition from other sources; maintenance fluids contributed 29% (IQR, 13%-60%) of the total daily fluid intake. Children ≥ 1 year of age received a median of 18 mL/kg (IQR, 9-37) of maintenance fluid in addition to 39 mL/kg (IQR, 25-53) of fluid and nutrition from other sources; maintenance fluids contributed 33% (IQR, 17%-69%) of the total daily fluid intake. When compared with similar data from 2011, there was no change in the amount of maintenance fluid given, which was administered mostly as isotonic fluids.
Conclusion:
Maintenance fluid contributes about a third of total fluid administration in children in Australian and New Zealand PICUs and is mostly administered as isotonic solutions.
