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Fluid Therapy: Friend or Foe?

Erin Grace1, Amy K Keir1

  • 1Department of Neonatal Medicine, Women's and Children's Hospital, North Adelaide, South Australia; SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia; Adelaide Medical School and the Robinson Research Institute, University of Adelaide, Adelaide, South Australia.

Clinics in Perinatology
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Fluid bolus therapy in neonatal critical care requires careful consideration. Excessive intravenous fluids and positive fluid balance in early life may be associated with harm to neonates.

Keywords:
Fluid therapy/methodsInfantNewborn

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Area of Science:

  • Neonatology
  • Critical Care Medicine
  • Pediatric Fluid Management

Background:

  • Fluid bolus therapy and fluid management are critical in neonatal, pediatric, and adult critical care.
  • Uncertainty exists regarding optimal fluid strategies in neonatal critical care.
  • Excessive intravenous fluid administration poses potential risks.

Purpose of the Study:

  • To review key clinical aspects of fluid bolus therapy and fluid balance in neonates within the first 7 days of life.
  • To explore potential harms of excessive intravenous fluids, drawing parallels from pediatric and adult critical care literature.
  • To suggest areas for future research in neonatal fluid management.

Main Methods:

  • Literature review of pediatric and adult critical care data.
  • Exploration of clinical aspects of fluid bolus therapy in neonates.
  • Analysis of early-life fluid balance in neonatal critical care.

Main Results:

  • Current data suggest a potential association between fluid bolus therapy and harm in neonates.
  • Positive fluid balance in the early neonatal period may be linked to adverse outcomes.
  • Evidence from adult and pediatric critical care highlights risks of excessive fluid administration.

Conclusions:

  • Fluid bolus therapy and early positive fluid balance in neonates warrant cautious application.
  • Further research is needed to establish optimal fluid management protocols in neonatal critical care.
  • Findings suggest potential relevance of adult and pediatric fluid management data to neonatology.