Maintenance intravenous fluid prescribing practices among paediatric residents
Article first published online: 27 JUL 2012
© 2012 The Author(s)/Acta Pædiatrica © 2012 Foundation Acta Pædiatrica
Volume 101, Issue 10, pages e465–e468, October 2012
How to Cite
Freeman, M., Ayus, J. and Moritz, M. (2012), Maintenance intravenous fluid prescribing practices among paediatric residents. Acta Paediatrica, 101: e465–e468. doi: 10.1111/j.1651-2227.2012.02780.x
- Issue published online: 29 AUG 2012
- Article first published online: 27 JUL 2012
- Accepted manuscript online: 5 JUL 2012 02:01PM EST
- Received 9 May 2012; revised 29 June 2012; accepted 2 July 2012.
- Fluid therapy;
Aim: To investigate the sodium composition of maintenance intravenous fluids (mIVF) used by paediatric residents throughout the United States in common clinical scenarios of arginine vasopressin (AVP) excess.
Methods: We distributed an online survey to paediatric residency programmes asking what type of mIVF (0.2%, 0.45%, 0.9% NaCl or lactated Ringer’s solution) they would administer in four common clinical scenarios of AVP excess (gastroenteritis, pneumonia, meningitis and postoperative) in both a 6-month-old (mo) and a 13-year-old (yo) child.
Results: We had 472 responses, representing 5% of the total paediatric residency population in the United States. Hypotonic mIVF were selected in 78% of children (88.2% of 6 mo and 68.5% of 13 yo). Isotonic mIVF were selected approximately twice as often for patients with meningitis as for those without (21.4% vs. 8.7% 6 mo and 42.8% vs. 27.7% 13 yo; p < 0.001).
Conclusions: The majority of US paediatric residents would prescribe hypotonic mIVF in disease states associated with AVP excess. However, a significant number of residents are using isotonic mIVF. Isotonic fluids are more likely to be prescribed in older children and children with meningitis.