Perioperative fluid management and postoperative hyponatremia in children

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
Gia J Oh, Scott M Sutherland

Abstract

Intravenous (IV) fluids are used ubiquitously when children undergo surgical procedures. Until recently, Holliday and Segar's guidelines for calculating maintenance fluids dictated fluid management strategies in postoperative pediatric patients. An increased recognition of hospital-acquired hyponatremia and its associated morbidity has led to a critical re-examination of IV fluid management in this population. Postsurgical patients are at high risk of developing hyponatremia due to the presence of non-osmotic stimuli for antidiuretic hormone release. Recent studies have established that, as they are administered in current practice, hypotonic maintenance fluids are associated with increased rates of hyponatremia. The best available data demonstrate that administration of isotonic fluid reduces hyponatremic risk. In this review, we discuss the collective data available on the subject and offer guidelines for fluid management and therapeutic monitoring.

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Citations

Nov 14, 2018·Frontiers in Pediatrics·Rupesh RainaShyam B Bansal
Aug 25, 2015·Pediatric Transplantation·Keri DrakeJens Goebel
Oct 30, 2020·Archives of Disease in Childhood·Milan ChromekLars Hagander
Feb 16, 2021·Journal of Pediatric Intensive Care·Matjaž Kopač

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