Intravenous Maintenance Fluids Revisited
ABSTRACTIntravenous maintenance fluid therapy aims to replace daily urinary and insensible losses for ill children in whom adequate enteric administration of fluids is contraindicated or infeasible. The traditional determination of fluid volumes and composition dates back to Holliday and Segar’s sem...
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Veröffentlicht in: | Pediatric emergency care 2013-11, Vol.29 (11), p.1225-1228 |
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creator | Cavari, Yuval Pitfield, Alexander F. Kissoon, Niranjan |
description | ABSTRACTIntravenous maintenance fluid therapy aims to replace daily urinary and insensible losses for ill children in whom adequate enteric administration of fluids is contraindicated or infeasible. The traditional determination of fluid volumes and composition dates back to Holliday and Segar’s seminal article from 1957, which describes the relationship between weight, energy expenditure, and physiologic losses in healthy children. Combined with estimates of daily electrolyte requirements, this information supports the use of the hypotonic maintenance fluids that were widely used in pediatric medicine. However, using hypotonic intravenous fluids in a contemporary hospitalized patient who may have complex physiologic derangements, less caloric expenditure, decreased urinary output, and elevated antidiuretic hormone levels is often not optimal; evidence over the last 2 decades shows that it may lead to an increased incidence of hyponatremia. In this review, we present the evidence for using isotonic rather than hypotonic fluids as intravenous maintenance fluid. |
doi_str_mv | 10.1097/PEC.0b013e3182aa4e2a |
format | Article |
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The traditional determination of fluid volumes and composition dates back to Holliday and Segar’s seminal article from 1957, which describes the relationship between weight, energy expenditure, and physiologic losses in healthy children. Combined with estimates of daily electrolyte requirements, this information supports the use of the hypotonic maintenance fluids that were widely used in pediatric medicine. However, using hypotonic intravenous fluids in a contemporary hospitalized patient who may have complex physiologic derangements, less caloric expenditure, decreased urinary output, and elevated antidiuretic hormone levels is often not optimal; evidence over the last 2 decades shows that it may lead to an increased incidence of hyponatremia. In this review, we present the evidence for using isotonic rather than hypotonic fluids as intravenous maintenance fluid.</description><identifier>ISSN: 0749-5161</identifier><identifier>EISSN: 1535-1815</identifier><identifier>DOI: 10.1097/PEC.0b013e3182aa4e2a</identifier><identifier>PMID: 24196097</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins, Inc</publisher><subject>Body Water - metabolism ; Child ; Critical Care - methods ; Critical Illness - therapy ; Disease Management ; Diuresis ; Elective Surgical Procedures ; Electrolytes - administration & dosage ; Electrolytes - blood ; Energy Metabolism ; Fluid Therapy - adverse effects ; Fluid Therapy - methods ; Humans ; Hyponatremia - chemically induced ; Hypotonic Solutions - administration & dosage ; Hypotonic Solutions - adverse effects ; Hypotonic Solutions - pharmacology ; Hypotonic Solutions - therapeutic use ; Infusions, Intravenous ; Isotonic Solutions - administration & dosage ; Isotonic Solutions - pharmacology ; Isotonic Solutions - therapeutic use ; Postoperative Care - methods ; Randomized Controlled Trials as Topic ; Vasopressins - secretion ; Water-Electrolyte Imbalance - chemically induced ; Water-Electrolyte Imbalance - prevention & control</subject><ispartof>Pediatric emergency care, 2013-11, Vol.29 (11), p.1225-1228</ispartof><rights>2013 Lippincott Williams & Wilkins, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3528-69eeef586c3ccd49185a01865bbeb43d571ca78a0f9e70887f56f8bcf0705be73</citedby><cites>FETCH-LOGICAL-c3528-69eeef586c3ccd49185a01865bbeb43d571ca78a0f9e70887f56f8bcf0705be73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24196097$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cavari, Yuval</creatorcontrib><creatorcontrib>Pitfield, Alexander F.</creatorcontrib><creatorcontrib>Kissoon, Niranjan</creatorcontrib><title>Intravenous Maintenance Fluids Revisited</title><title>Pediatric emergency care</title><addtitle>Pediatr Emerg Care</addtitle><description>ABSTRACTIntravenous maintenance fluid therapy aims to replace daily urinary and insensible losses for ill children in whom adequate enteric administration of fluids is contraindicated or infeasible. The traditional determination of fluid volumes and composition dates back to Holliday and Segar’s seminal article from 1957, which describes the relationship between weight, energy expenditure, and physiologic losses in healthy children. Combined with estimates of daily electrolyte requirements, this information supports the use of the hypotonic maintenance fluids that were widely used in pediatric medicine. However, using hypotonic intravenous fluids in a contemporary hospitalized patient who may have complex physiologic derangements, less caloric expenditure, decreased urinary output, and elevated antidiuretic hormone levels is often not optimal; evidence over the last 2 decades shows that it may lead to an increased incidence of hyponatremia. In this review, we present the evidence for using isotonic rather than hypotonic fluids as intravenous maintenance fluid.</description><subject>Body Water - metabolism</subject><subject>Child</subject><subject>Critical Care - methods</subject><subject>Critical Illness - therapy</subject><subject>Disease Management</subject><subject>Diuresis</subject><subject>Elective Surgical Procedures</subject><subject>Electrolytes - administration & dosage</subject><subject>Electrolytes - blood</subject><subject>Energy Metabolism</subject><subject>Fluid Therapy - adverse effects</subject><subject>Fluid Therapy - methods</subject><subject>Humans</subject><subject>Hyponatremia - chemically induced</subject><subject>Hypotonic Solutions - administration & dosage</subject><subject>Hypotonic Solutions - adverse effects</subject><subject>Hypotonic Solutions - pharmacology</subject><subject>Hypotonic Solutions - therapeutic use</subject><subject>Infusions, Intravenous</subject><subject>Isotonic Solutions - administration & dosage</subject><subject>Isotonic Solutions - pharmacology</subject><subject>Isotonic Solutions - therapeutic use</subject><subject>Postoperative Care - methods</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Vasopressins - secretion</subject><subject>Water-Electrolyte Imbalance - chemically induced</subject><subject>Water-Electrolyte Imbalance - prevention & control</subject><issn>0749-5161</issn><issn>1535-1815</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUF1Lw0AQPESxtfoPRPrYl9Tb3GcepbRaqCiiz8flsqHRNKl3SYv_3pP6AS4sy7Izs8MQcgl0CjRT14_z2ZTmFBgy0Km1HFN7RIYgmEhAgzgmQ6p4lgiQMCBnIbxSGo-MnZJByiGTUWRIJsum83aHTduH8b2tmg4b2zgcL-q-KsL4CXdVqDoszslJaeuAF99zRF4W8-fZXbJ6uF3OblaJYyLVicwQsRRaOuZcwTPQwlLQUuQ55pwVQoGzSltaZqio1qoUstS5K6miIkfFRmRy0N369r3H0JlNFRzWtW0wejTAeaakFKAjlB-gzrcheCzN1lcb6z8MUPOVkYkZmf8ZRdrV94c-32DxS_oJ5U9339Yd-vBW93v0Zo227taGxpJCiiSNugBxS2JHO58TTnJ9</recordid><startdate>201311</startdate><enddate>201311</enddate><creator>Cavari, Yuval</creator><creator>Pitfield, Alexander F.</creator><creator>Kissoon, Niranjan</creator><general>Lippincott Williams & Wilkins, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201311</creationdate><title>Intravenous Maintenance Fluids Revisited</title><author>Cavari, Yuval ; Pitfield, Alexander F. ; Kissoon, Niranjan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3528-69eeef586c3ccd49185a01865bbeb43d571ca78a0f9e70887f56f8bcf0705be73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Body Water - metabolism</topic><topic>Child</topic><topic>Critical Care - methods</topic><topic>Critical Illness - therapy</topic><topic>Disease Management</topic><topic>Diuresis</topic><topic>Elective Surgical Procedures</topic><topic>Electrolytes - administration & dosage</topic><topic>Electrolytes - blood</topic><topic>Energy Metabolism</topic><topic>Fluid Therapy - adverse effects</topic><topic>Fluid Therapy - methods</topic><topic>Humans</topic><topic>Hyponatremia - chemically induced</topic><topic>Hypotonic Solutions - administration & dosage</topic><topic>Hypotonic Solutions - adverse effects</topic><topic>Hypotonic Solutions - pharmacology</topic><topic>Hypotonic Solutions - therapeutic use</topic><topic>Infusions, Intravenous</topic><topic>Isotonic Solutions - administration & dosage</topic><topic>Isotonic Solutions - pharmacology</topic><topic>Isotonic Solutions - therapeutic use</topic><topic>Postoperative Care - methods</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Vasopressins - secretion</topic><topic>Water-Electrolyte Imbalance - chemically induced</topic><topic>Water-Electrolyte Imbalance - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cavari, Yuval</creatorcontrib><creatorcontrib>Pitfield, Alexander F.</creatorcontrib><creatorcontrib>Kissoon, Niranjan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric emergency care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cavari, Yuval</au><au>Pitfield, Alexander F.</au><au>Kissoon, Niranjan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intravenous Maintenance Fluids Revisited</atitle><jtitle>Pediatric emergency care</jtitle><addtitle>Pediatr Emerg Care</addtitle><date>2013-11</date><risdate>2013</risdate><volume>29</volume><issue>11</issue><spage>1225</spage><epage>1228</epage><pages>1225-1228</pages><issn>0749-5161</issn><eissn>1535-1815</eissn><abstract>ABSTRACTIntravenous maintenance fluid therapy aims to replace daily urinary and insensible losses for ill children in whom adequate enteric administration of fluids is contraindicated or infeasible. The traditional determination of fluid volumes and composition dates back to Holliday and Segar’s seminal article from 1957, which describes the relationship between weight, energy expenditure, and physiologic losses in healthy children. Combined with estimates of daily electrolyte requirements, this information supports the use of the hypotonic maintenance fluids that were widely used in pediatric medicine. However, using hypotonic intravenous fluids in a contemporary hospitalized patient who may have complex physiologic derangements, less caloric expenditure, decreased urinary output, and elevated antidiuretic hormone levels is often not optimal; evidence over the last 2 decades shows that it may lead to an increased incidence of hyponatremia. 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subjects | Body Water - metabolism Child Critical Care - methods Critical Illness - therapy Disease Management Diuresis Elective Surgical Procedures Electrolytes - administration & dosage Electrolytes - blood Energy Metabolism Fluid Therapy - adverse effects Fluid Therapy - methods Humans Hyponatremia - chemically induced Hypotonic Solutions - administration & dosage Hypotonic Solutions - adverse effects Hypotonic Solutions - pharmacology Hypotonic Solutions - therapeutic use Infusions, Intravenous Isotonic Solutions - administration & dosage Isotonic Solutions - pharmacology Isotonic Solutions - therapeutic use Postoperative Care - methods Randomized Controlled Trials as Topic Vasopressins - secretion Water-Electrolyte Imbalance - chemically induced Water-Electrolyte Imbalance - prevention & control |
title | Intravenous Maintenance Fluids Revisited |
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