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[Perioperative Infusion Therapy in Children]

Robert Sümpelmann, Rolf Zander, Lars Witt

    Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
    |May 21, 2020
    PubMed

    Insights

    Optimizing intravenous fluid therapy in pediatric anesthesia is crucial. Balanced, isotonic electrolyte solutions with glucose are recommended for safety and efficacy, preventing complications like hyponatremia.

    Area of Science:

    • Pediatric Anesthesiology
    • Intravenous Fluid Therapy
    • Perioperative Care

    Background:

    • Intravenous fluid composition during pediatric anesthesia has long been debated.
    • Errors in perioperative infusion therapy can lead to severe complications in children.
    • Evidence-based recommendations are needed for safe and effective fluid management.

    Purpose of the Study:

    • To review historical and recent developments in pediatric perioperative fluid management.
    • To provide recommendations focused on safety and efficacy.
    • To highlight the physiological basis of fluid therapy in children.

    Main Methods:

    • Review of historical and recent literature on pediatric fluid management.
    • Analysis of physiological principles guiding fluid therapy.
    • Focus on safety and efficacy of different intravenous fluid types.

    Main Results:

    • Optimized preoperative fasting and liberal clear fluid intake improve patient condition post-anesthesia.
    • Balanced isotonic electrolyte solutions are safer than hypotonic solutions or 0.9% saline.
    • 1-2% glucose in maintenance fluids prevents hypoglycemia and hyperglycemia.
    • Colloids like fluid gelatine or hydroxyethyl starch can manage circulatory instability.

    Conclusions:

    • Physiologically composed infusion solutions benefit homeostasis in children.
    • These solutions offer a wider safety margin, even with accidental over-infusion.
    • Optimized fluid management enhances perioperative outcomes in pediatric patients.

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