Intravenous Fluid Management in the Pediatric Hospital Setting: Is Isotonic Fluid the Right Approach for all Patients?

Author:

Edelson Jonathan B.,Orenstein Evan W.,Zaoutis Lisa B.,Copelovitch Lawrence

Publisher

Springer Science and Business Media LLC

Subject

Pediatrics, Perinatology and Child Health

Reference40 articles.

1. Jain S, Elon LKM, Johnson BA, Frank G, DeGuzman M. Physician practice variation in the pediatric emergency department and its impact on resource use and quality of care. Pediatr Emerg Care. 2010;26(12):902–8.

2. Freeman M, Ayus J, Moritz M. Maintenance intravenous fluid prescribing practices among paediatric residents: Maintenance intravenous fluid prescribing practices. Acta Paediatr. 2012;101(10):e465–8.

3. Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics. 1957;19(5):823–32.

4. Wang J, Xu E, Xiao Y. Isotonic versus hypotonic maintenance IV fluids in hospitalized children: a meta-analysis. Pediatrics. 2014;133(1):105–13. This meta-analysis, which examined 10 randomized control trials of pediatric patients receiving intravenous fluids, concluded that isotonic maintenance fluids were safer for pediatric patients than hypotonic maintenance fluids due to the risk of hyponatremia associated with hypotonic fluids.

5. Foster BA, Tom D, Hill V. Hypotonic versus isotonic fluids in hospitalized children: a systematic review and meta-analysis. J Pediatr. 2014;165(1):163–9. This systematic review and meta-analysis examined 10 randomized control trials of hospitalized children receiving IV fluids and demonstrated an increased relative risk of hyponatremia in those patients receiving hypotonic fluids in comparison with those who received isotonic fluids. However, the authors noted in their thoughtful discussion that randomized studies were mostly performed in ICU settings or with post-operative patients and that few comparisons were done between isotonic fluid and 0.45 % saline.

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