Related Experiment Video
Updated: May 2, 2026
08:07
Rose Bengal Photothrombosis by Confocal Optical Imaging In Vivo: A Model of Single Vessel Stroke
Published on: June 23, 2015
15.3K
The ROSE framework for fluid therapy in critically ill pediatric patients
Romina Aparecida Dos Santos Gomes1,2, Manu L N G Malbrain3,4,5, Adriana Teixeira Rodrigues1,2
1Department of Pediatrics, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Anaesthesiology Intensive Therapy
|March 4, 2026
Summary
The ROSE framework is applicable for pediatric fluid management, showing feasibility and potential for individualizing care. While fluid accumulation was similar, adherence improved post-training.
Area of Science:
- Pediatric Critical Care Medicine
- Fluid Management Strategies
- Clinical Framework Implementation
Background:
- Critically ill children often experience fluid overload, impacting outcomes.
- The Resuscitation, Optimization, Stabilization, Evacuation (ROSE) framework offers a structured approach to fluid therapy.
- Assessing the ROSE framework's applicability in pediatric intensive care is crucial.
Purpose of the Study:
- To evaluate the feasibility and impact of the ROSE framework on fluid management in critically ill pediatric patients.
- To assess the framework's effectiveness in preventing fluid accumulation and improving clinical outcomes.
- To benchmark fluid accumulation percentages (FA%) across different phases of the ROSE framework.
Main Methods:
- A quasi-experimental study comparing retrospective and prospective cohorts (n=122) of mechanically ventilated, vasoactive-dependent children.
- Implementation of structured training on ROSE-guided fluid management for the prospective cohort.
- Outcomes measured included fluid accumulation percentage (FA%), mechanical ventilation duration, PICU length of stay, and need for renal replacement therapy (RRT).
Main Results:
- Fluid accumulation percentage (FA%) remained similar between retrospective and prospective cohorts across multiple time points.
- FA% was comparable during Resuscitation, Optimization, and Evacuation phases, but higher during Stabilization in the prospective cohort.
- Adherence to FA% targets increased from 67.9% to 72.4% after ROSE framework implementation; other clinical outcomes were similar.
Conclusions:
- The ROSE framework is a feasible approach for managing fluid therapy in critically ill pediatric patients.
- It provides valuable benchmarking for controlling fluid accumulation and shows promise for personalized fluid management.
- Further validation in centers not previously exposed to the ROSE framework is recommended.
Related Concept Videos
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
817
Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
817
01:29Acute Respiratory Failure-V
768
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
768
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
408
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
408
01:26Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
414
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
414
01:22Heart Failure VI: Adjunct Therapies
632
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
632
01:30Continuous Renal Replacement Therapy
2.3K
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
2.3K