Clinical practice guideline

Maintenance intravenous fluids in children

Leonard G. Feld, Daniel R. Neuspiel, Byron (Alex) Foster, Michael G. Leu, Matthew D. Garber, Kelly Austin, Rajit K. Basu, Edward E. Conway, James J. Fehr, Clare Hawkins, Ron L. Kaplan, Echo V. Rowe, Muhammad Waseem, Michael L. Moritz

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Maintenance intravenous fluids (IVFs) are used to provide critical supportive care for children who are acutely ill. IVFs are required if sufficient fluids cannot be provided by using enteral administration for reasons such as gastrointestinal illness, respiratory compromise, neurologic impairment, a perioperative state, or being moribund from an acute or chronic illness. Despite the common use of maintenance IVFs, there is high variability in fluid prescribing practices and a lack of guidelines for fluid composition administration and electrolyte monitoring. The administration of hypotonic IVFs has been the standard in pediatrics. Concerns have been raised that this approach results in a high incidence of hyponatremia and that isotonic IVFs could prevent the development of hyponatremia. Our goal in this guideline is to provide an evidence-based approach for choosing the tonicity of maintenance IVFs in most patients from 28 days to 18 years of age who require maintenance IVFs. This guideline applies to children in surgical (postoperative) and medical acute-care settings, including critical care and the general inpatient ward. Patients with neurosurgical disorders, congenital or acquired cardiac disease, hepatic disease, cancer, renal dysfunction, diabetes insipidus, voluminous watery diarrhea, or severe burns; neonates who are younger than 28 days old or in the NICU; and adolescents older than 18 years old are excluded. We specifically address the tonicity of maintenance IVFs in children.

Original languageEnglish (US)
Article numbere20183083
JournalPediatrics
Volume142
Issue number6
DOIs
StatePublished - Dec 1 2018

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Practice Guidelines
Maintenance
Hyponatremia
Guidelines
Critical Care
Patients' Rooms
Congenital, Hereditary, and Neonatal Diseases and Abnormalities
Diabetes Insipidus
Liver Neoplasms
Burns
Intravenous Administration
Nervous System
Electrolytes
Small Intestine
Inpatients
Diarrhea
Heart Diseases
Chronic Disease
Newborn Infant
Pediatrics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Feld, L. G., Neuspiel, D. R., Foster, B. A., Leu, M. G., Garber, M. D., Austin, K., ... Moritz, M. L. (2018). Clinical practice guideline: Maintenance intravenous fluids in children. Pediatrics, 142(6), [e20183083]. https://doi.org/10.1542/peds.2018-3083

Clinical practice guideline : Maintenance intravenous fluids in children. / Feld, Leonard G.; Neuspiel, Daniel R.; Foster, Byron (Alex); Leu, Michael G.; Garber, Matthew D.; Austin, Kelly; Basu, Rajit K.; Conway, Edward E.; Fehr, James J.; Hawkins, Clare; Kaplan, Ron L.; Rowe, Echo V.; Waseem, Muhammad; Moritz, Michael L.

In: Pediatrics, Vol. 142, No. 6, e20183083, 01.12.2018.

Research output: Contribution to journalArticle

Feld, LG, Neuspiel, DR, Foster, BA, Leu, MG, Garber, MD, Austin, K, Basu, RK, Conway, EE, Fehr, JJ, Hawkins, C, Kaplan, RL, Rowe, EV, Waseem, M & Moritz, ML 2018, 'Clinical practice guideline: Maintenance intravenous fluids in children', Pediatrics, vol. 142, no. 6, e20183083. https://doi.org/10.1542/peds.2018-3083
Feld LG, Neuspiel DR, Foster BA, Leu MG, Garber MD, Austin K et al. Clinical practice guideline: Maintenance intravenous fluids in children. Pediatrics. 2018 Dec 1;142(6). e20183083. https://doi.org/10.1542/peds.2018-3083
Feld, Leonard G. ; Neuspiel, Daniel R. ; Foster, Byron (Alex) ; Leu, Michael G. ; Garber, Matthew D. ; Austin, Kelly ; Basu, Rajit K. ; Conway, Edward E. ; Fehr, James J. ; Hawkins, Clare ; Kaplan, Ron L. ; Rowe, Echo V. ; Waseem, Muhammad ; Moritz, Michael L. / Clinical practice guideline : Maintenance intravenous fluids in children. In: Pediatrics. 2018 ; Vol. 142, No. 6.
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