Intravenous fluid choices in critically ill children

@article{Carcillo2014IntravenousFC,
  title={Intravenous fluid choices in critically ill children},
  author={Joseph Carcillo},
  journal={Current Opinion in Critical Care},
  year={2014},
  volume={20},
  pages={396–401}
}
  • J. Carcillo
  • Published 1 August 2014
  • Medicine
  • Current Opinion in Critical Care
Purpose of reviewTo review the past year's literature, and selected prior literature relevant to these most recent findings, regarding intravenous fluid choices in the management of critically ill children. Recent findingsTwenty-eight publications were identified using the keywords pediatrics and intravenous fluid in the PubMed database. The subjects identified included intravenous fluid choices related to perioperative maintenance fluid management, rehydration for dehydration related to… 
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24 Citations
Highly Influential Citations
2
Background Citations
5
Methods Citations
2

24 Citations

Citation Type

Citation Type

Impact of balanced versus unbalanced fluid resuscitation on clinical outcomes in critically ill children: protocol for a systematic review and meta-analysis
TLDR
The present review will summarize current available data in the literature and assess whether recommendations can be generated regarding the choice of crystalloids or otherwise identify knowledge gaps which will open the door to a large-scale randomized controlled trial (RCT).
Fluid Overload in Critically Ill Children
TLDR
The current literature demonstrates that “clinically significant” degree of FO could be below 10% and the lack of a standardized method to assess FB (fluid balance) and a universal definition of FO are issues that need to be addressed.
Suitable intravenous fluid for preventing dysnatremia in children with gastroenteritis; a randomized clinical trial
TLDR
It seems that administering isotonic fluids regardless of the types of dysnatremia can be recommended to lessen clinicians’ conflicting decision-making in selecting an appropriate fluid.
Impact of perioperative hyponatremia in children: A narrative review.
TLDR
The literature is reviewed and the impact of perioperative hyponatremia in children is described, which represents an emergency condition, and early diagnosis, prompt treatment and close monitoring are essential to reduce morbidity and mortality.
Perioperative intravenous fluid therapy in children: guidelines from the Association of the Scientific Medical Societies in Germany
TLDR
Perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis and the additional use of colloids is recommended to recover normovolemia and to avoid fluid overload when crystalloids alone are not sufficient and blood products are not indicated.
Management of Diarrhoeal Dehydration in Childhood: A Review for Clinicians in Developing Countries
TLDR
The article uses the clinical case examples to illustrate the bed-side approach to the management of three different types of dehydration using a pre-mixed isotonic fluid solution (with 20 or 40 mmol/L of potassium chloride added depending on the absence or presence of hypokalemia, respectively).
Fluid Status Assessment and Management During the Perioperative Phase in Pediatric Cardiac Surgery Patients.
TLDR
In cardiac surgery patients, the distribution of fluids in the intravascular or extravascular spaces depends on a number of intraoperative and postoperative factors that highly influence the pathophysiology of body fluid kinetics, including the patients’ body surface area.
Coming Full Circle: Thirty Years of Paediatric Fluid Resuscitation
TLDR
Given the ubiquity ofFBT and the potential for harm, appropriately powered examinations of the efficacy of FBT compared to alternative interventions in the paediatric emergency and ICU settings in the developed world appear justified and warranted.
Association Between Hyponatremia and Maintenance Intravenous Solutions in Critically Ill Children: A Retrospective Observational Study
TLDR
Hyponatremia associated with the use of hypotonic maintenance solutions occurs in one out of four children in intensive care, and the main risk groups are post-operative patients and those who receive loop diuretics.
Recommendations for the management of pediatric septic shock in the first hour (part one).
TLDR
The proposal is to shift the paradigm from an "individual practice guideline," which is universal for all, to an "institutional practice guideline" and to assess the factors that should be improved at each facility and to analyze the bundles for the early detection of septic shock.
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References

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TLDR
The findings and the similarity of fluid balance patterns in the cohort to adults in the Fluid and Catheter Treatment Trial liberal arm demonstrate the need to determine whether a conservative fluid management strategy improves clinical outcomes in children with acute lung injury and support a Bayesian trial mirroring the Fl fluid balance trial.
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TLDR
Although treatment with Ringer's lactate resulted in less rapid improvement in the hematocrit and a marginally longer time to initial recovery than did treatment with either of the colloid solutions, there were no differences in all other measures of treatment response.
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TLDR
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TLDR
Current understanding of the problem is outlined, recent research is summarized and detailed recommendations are made for the prescription of IV maintenance fluids in children between one month and 18 years of age.
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TLDR
The evidence for using isotonic rather than hypotonic fluids as intravenous maintenance fluid is presented, and evidence over the last 2 decades shows that it may lead to an increased incidence of hyponatremia.
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TLDR
A randomized blinded comparison of 4 fluids for initial resuscitation of 230 Vietnamese children with dengue shock syndrome found no clear advantage to using any of the 4 fluids, but the longest recovery times occurred in the lactated Ringer's group.
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TLDR
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Isotonic Versus Hypotonic Maintenance IV Fluids in Hospitalized Children: A Meta-Analysis
TLDR
Isotonic fluids are safer than hypotonic fluids in hospitalized children requiring maintenance IV fluid therapy in terms of pNa, and none of the findings was sensitive to imputation of missing data.
Exploring mechanisms of excess mortality with early fluid resuscitation: insights from the FEAST trial
TLDR
Excess mortality from boluses occurred in all subgroups of children and should prompt a re-evaluation of evidence on fluid resuscitation for shock and are-appraisal of the rate, composition and volume of resuscitation fluids.
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