Fluid therapy for children: facts, fashions and questions
Fluid therapy restores circulation by expanding extracellular fluid. However, a dispute has arisen regarding the nature of intravenous therapy for acutely ill children following the development of acute hyponatraemia from overuse of hypotonic saline. The foundation on which correct maintenance fluid...
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| Veröffentlicht in: | Archives of disease in childhood 2007-06, Vol.92 (6), p.546-550 |
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| creator | Holliday, Malcolm A Ray, Patricio E Friedman, Aaron L |
| description | Fluid therapy restores circulation by expanding extracellular fluid. However, a dispute has arisen regarding the nature of intravenous therapy for acutely ill children following the development of acute hyponatraemia from overuse of hypotonic saline. The foundation on which correct maintenance fluid therapy is built is examined and the difference between maintenance fluid therapy and restoration or replenishment fluid therapy for reduction in extracellular fluid volume is delineated. Changing practices and the basic physiology of extracellular fluid are discussed. Some propose changing the definition of “maintenance therapy” and recommend isotonic saline be used as maintenance and restoration therapy in undefined amounts leading to excess intravenous sodium chloride intake. Intravenous fluid therapy for children with volume depletion should first restore extracellular volume with measured infusions of isotonic saline followed by defined, appropriate maintenance therapy to replace physiological losses according to principles established 50 years ago. |
| doi_str_mv | 10.1136/adc.2006.106377 |
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However, a dispute has arisen regarding the nature of intravenous therapy for acutely ill children following the development of acute hyponatraemia from overuse of hypotonic saline. The foundation on which correct maintenance fluid therapy is built is examined and the difference between maintenance fluid therapy and restoration or replenishment fluid therapy for reduction in extracellular fluid volume is delineated. Changing practices and the basic physiology of extracellular fluid are discussed. Some propose changing the definition of “maintenance therapy” and recommend isotonic saline be used as maintenance and restoration therapy in undefined amounts leading to excess intravenous sodium chloride intake. Intravenous fluid therapy for children with volume depletion should first restore extracellular volume with measured infusions of isotonic saline followed by defined, appropriate maintenance therapy to replace physiological losses according to principles established 50 years ago.</description><identifier>ISSN: 0003-9888</identifier><identifier>EISSN: 1468-2044</identifier><identifier>DOI: 10.1136/adc.2006.106377</identifier><identifier>PMID: 17175577</identifier><identifier>CODEN: ADCHAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</publisher><subject>Biological and medical sciences ; Body Composition ; Care and treatment ; Child ; Childhood diarrhea ; Dehydration (Physiology) ; Dehydration - etiology ; Dehydration - therapy ; Diarrhea - complications ; Diarrhea - therapy ; Diarrhea in children ; Electrolytes ; Evaluation ; Fluid therapy ; Fluid Therapy - adverse effects ; Fluid Therapy - methods ; Fluids ; General aspects ; Glucose ; Humans ; Hyponatremia - etiology ; Load ; Maintenance ; Medical sciences ; Miscellaneous ; Physiology ; Potassium ; Prevention and actions ; Public health. 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However, a dispute has arisen regarding the nature of intravenous therapy for acutely ill children following the development of acute hyponatraemia from overuse of hypotonic saline. The foundation on which correct maintenance fluid therapy is built is examined and the difference between maintenance fluid therapy and restoration or replenishment fluid therapy for reduction in extracellular fluid volume is delineated. Changing practices and the basic physiology of extracellular fluid are discussed. Some propose changing the definition of “maintenance therapy” and recommend isotonic saline be used as maintenance and restoration therapy in undefined amounts leading to excess intravenous sodium chloride intake. Intravenous fluid therapy for children with volume depletion should first restore extracellular volume with measured infusions of isotonic saline followed by defined, appropriate maintenance therapy to replace physiological losses according to principles established 50 years ago.</description><subject>Biological and medical sciences</subject><subject>Body Composition</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Childhood diarrhea</subject><subject>Dehydration (Physiology)</subject><subject>Dehydration - etiology</subject><subject>Dehydration - therapy</subject><subject>Diarrhea - complications</subject><subject>Diarrhea - therapy</subject><subject>Diarrhea in children</subject><subject>Electrolytes</subject><subject>Evaluation</subject><subject>Fluid therapy</subject><subject>Fluid Therapy - adverse effects</subject><subject>Fluid Therapy - methods</subject><subject>Fluids</subject><subject>General aspects</subject><subject>Glucose</subject><subject>Humans</subject><subject>Hyponatremia - etiology</subject><subject>Load</subject><subject>Maintenance</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Physiology</subject><subject>Potassium</subject><subject>Prevention and actions</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Rehydration Solutions - chemistry</subject><subject>Review</subject><subject>Rodents</subject><subject>Scientific Concepts</subject><subject>Sodium</subject><subject>Sodium chloride</subject><subject>Sodium Chloride - administration & dosage</subject><subject>Studies</subject><subject>Teaching Methods</subject><subject>Urine</subject><subject>Water</subject><subject>Young Children</subject><issn>0003-9888</issn><issn>1468-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkUtvEzEURi0EoqGwZodGQmwQk16_PSyQSqA8VNEFz53l8XgSh4kd7Ami_x6HiRpYsbqyfO6nc_Uh9BDDHGMqzkxn5wRAzDEIKuUtNMNMqJoAY7fRDABo3SilTtC9nNcAmChF76ITLLHkXMoZai6Gne-qceWS2V5XfUyVXfmhSy48r3pjx_ysjLzyMeTKhK76sXN53L_uozu9GbJ7cJin6PPF60-Lt_Xl1Zt3i_PLuuUCxppywSTvmgbb1pCemraxLS8muAOpsDWEtbZjypLGCSwcs9ATILSokw64pKfoxZS73bUb11kXxmQGvU1-Y9K1jsbrf3-CX-ll_KkJiBLISsDjQ0CKf-z1Ou5SKM4aK6KIVEBVoeqJWprBaR9sDKP7Ndo4DG7pdDlpcaXPseC0KSt7rbOJtynmnFx_Y4RB77vRpRu970ZP3ZSNR38fcuQPZRTgyQEw2ZqhTyZYn4-ckpwyCUdVn4vizb9J37WQVHL94ctCvxKcvf_49Zt-WfinE99u1v-1_A1wGrFC</recordid><startdate>20070601</startdate><enddate>20070601</enddate><creator>Holliday, Malcolm A</creator><creator>Ray, Patricio E</creator><creator>Friedman, Aaron L</creator><general>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</general><general>BMJ</general><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><general>BMJ Group</general><scope>BSCLL</scope><scope>IQODW</scope><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>0-V</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88I</scope><scope>8A4</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0P</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>5PM</scope></search><sort><creationdate>20070601</creationdate><title>Fluid therapy for children: facts, fashions and questions</title><author>Holliday, Malcolm A ; Ray, Patricio E ; Friedman, Aaron L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b560t-356475d991cba2f3ab9cb50121d0781ca24bcd48c29e616e4c0f20230032d0573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Biological and medical sciences</topic><topic>Body Composition</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Childhood diarrhea</topic><topic>Dehydration (Physiology)</topic><topic>Dehydration - etiology</topic><topic>Dehydration - therapy</topic><topic>Diarrhea - complications</topic><topic>Diarrhea - therapy</topic><topic>Diarrhea in children</topic><topic>Electrolytes</topic><topic>Evaluation</topic><topic>Fluid therapy</topic><topic>Fluid Therapy - adverse effects</topic><topic>Fluid Therapy - methods</topic><topic>Fluids</topic><topic>General aspects</topic><topic>Glucose</topic><topic>Humans</topic><topic>Hyponatremia - etiology</topic><topic>Load</topic><topic>Maintenance</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Physiology</topic><topic>Potassium</topic><topic>Prevention and actions</topic><topic>Public health. Hygiene</topic><topic>Public health. 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However, a dispute has arisen regarding the nature of intravenous therapy for acutely ill children following the development of acute hyponatraemia from overuse of hypotonic saline. The foundation on which correct maintenance fluid therapy is built is examined and the difference between maintenance fluid therapy and restoration or replenishment fluid therapy for reduction in extracellular fluid volume is delineated. Changing practices and the basic physiology of extracellular fluid are discussed. Some propose changing the definition of “maintenance therapy” and recommend isotonic saline be used as maintenance and restoration therapy in undefined amounts leading to excess intravenous sodium chloride intake. 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| ispartof | Archives of disease in childhood, 2007-06, Vol.92 (6), p.546-550 |
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| source | BMJ Journals Online Archive; MEDLINE; PubMed Central; EZB Electronic Journals Library |
| subjects | Biological and medical sciences Body Composition Care and treatment Child Childhood diarrhea Dehydration (Physiology) Dehydration - etiology Dehydration - therapy Diarrhea - complications Diarrhea - therapy Diarrhea in children Electrolytes Evaluation Fluid therapy Fluid Therapy - adverse effects Fluid Therapy - methods Fluids General aspects Glucose Humans Hyponatremia - etiology Load Maintenance Medical sciences Miscellaneous Physiology Potassium Prevention and actions Public health. Hygiene Public health. Hygiene-occupational medicine Rehydration Solutions - chemistry Review Rodents Scientific Concepts Sodium Sodium chloride Sodium Chloride - administration & dosage Studies Teaching Methods Urine Water Young Children |
| title | Fluid therapy for children: facts, fashions and questions |
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