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Fluid Overload in Critically Ill Children.

Rupesh Raina1,2, Sidharth Kumar Sethi3, Nikita Wadhwani3

  • 1Department of Nephrology, Akron Children's Hospital and Cleveland Clinic Akron General, Akron, OH, United States.

Frontiers in Pediatrics
|November 14, 2018
PubMed
Summary
This summary is machine-generated.

Fluid overload (FO) in critically ill children is linked to adverse outcomes and mortality. Standardized definitions and assessment methods for FO are needed, with further research on early goal-directed therapy and hemodynamic parameters in pediatric resuscitation.

Keywords:
acute kidney injurycritical carefluid overloadintensive carepediatric nephrology

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Area of Science:

  • Pediatric Critical Care Medicine
  • Nephrology
  • Fluid Physiology

Background:

  • Fluid resuscitation is common in critically ill patients.
  • Excessive fluid administration can cause fluid overload (FO), leading to adverse effects and increased morbidity in pediatric critical care.
  • Understanding the impact of FO is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To review the literature on the impact of FO on outcomes in critically-ill children.
  • To examine the relationship between FO and critical illness.
  • To evaluate current pediatric fluid management guidelines.

Main Methods:

  • A comprehensive literature search was conducted using PubMed/Medline and Embase databases up to June 2017.
  • Two authors independently reviewed titles and abstracts for relevance.
  • Relevant articles and their reference lists were hand-searched for data synthesis.

Main Results:

  • Recent evidence suggests a link between mortality and FO, requiring validation through prospective randomized controlled trials.
  • A "clinically significant" degree of FO may be less than 10%.
  • Standardized methods for fluid balance assessment and a universal definition of FO are lacking.

Conclusions:

  • Further research, including prospective RCTs, is needed to confirm the relationship between FO and mortality.
  • Addressing the lack of standardized FO assessment and definition is critical.
  • The impact of early goal-directed therapy and hemodynamic parameters in pediatric resuscitation requires further exploration.