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Korean J Pediatr. 2013 Jul;56(7):282-5. doi: 10.3345/kjp.2013.56.7.282. Epub 2013 Jul 19.

Intravenous fluid prescription practices among pediatric residents in Korea.

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1
Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.

Abstract

PURPOSE:

Recent studies have established the association between hypotonic fluids administration and hospital-acquired hyponatremia in children. The present paper investigated the pattern of current practice in intravenous fluid prescription among Korean pediatric residents, to underscore the need for updated education.

METHODS:

A survey-based analysis was carried out. Pediatric residents at six university hospitals in Korea completed a survey consisting of four questions. Each question proposed a unique scenario in which the respondents had to prescribe either a hypotonic or an isotonic fluid for the patient.

RESULTS:

Ninety-one responses were collected and analyzed. In three of the four scenarios, a significant majority prescribed the hypotonic fluids (98.9%, 85.7%, and 69.2%, respectively). Notably, 69.2% of the respondents selected the hypotonic fluids for postoperative management. Almost all (96.7%) selected the isotonic fluids for hydration therapy.

CONCLUSION:

In the given scenarios, the majority of Korean pediatric residents would prescribe a hypotonic fluid, except for initial hydration. The current state of pediatric fluid management, notably, heightens the risk of hospital-acquired hyponatremia. Updated clinical practice education on intravenous fluid prescription, therefore, is urgently required.

KEYWORDS:

Fluid therapy; Hyponatremia; Infusions; Intravenous; Maintenance; Pediatrics

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