Clinical Practice Guideline: Maintenance Intravenous Fluids in Children.

Area of Science:

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

Background:

• Maintenance intravenous fluids (IVFs) are crucial for acutely ill children when enteral feeding is insufficient.
• Current pediatric IVF practices show significant variability and lack standardized guidelines for composition and monitoring.
• The traditional use of hypotonic IVFs in pediatrics is associated with a high incidence of hyponatremia.

Purpose of the Study:

• To provide an evidence-based guideline for selecting the tonicity of maintenance IVFs in pediatric patients.
• To address the optimal fluid composition and electrolyte monitoring for children aged 28 days to 18 years requiring IVFs.
• To reduce the incidence of hyponatremia in pediatric patients receiving maintenance IVFs.

Main Methods:

• Development of a clinical guideline based on an evidence-based approach.
• Focus on patients aged 28 days to 18 years requiring maintenance IVFs in acute care settings.
• Exclusion of specific patient populations with complex conditions or extreme age ranges.

Main Results:

• The guideline recommends isotonic IVFs with potassium chloride and dextrose for pediatric patients.
• This approach is strongly recommended to significantly decrease the risk of hyponatremia.
• Evidence quality is rated as A, indicating a strong recommendation.

Conclusions:

• Isotonic maintenance IVFs are recommended for pediatric patients aged 28 days to 18 years.
• This practice is crucial for preventing hyponatremia in this population.
• The guideline aims to standardize and improve the safety of intravenous fluid therapy in children.