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Acta Paediatr. 2012 Oct;101(10):e465-8. doi: 10.1111/j.1651-2227.2012.02780.x. Epub 2012 Jul 27.

Maintenance intravenous fluid prescribing practices among paediatric residents.

Author information

1
Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, PA 15224, USA.

Abstract

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.

PMID:
22765308
PMCID:
PMC4042841
DOI:
10.1111/j.1651-2227.2012.02780.x
[Indexed for MEDLINE]
Free PMC Article

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