Dataset Information

ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children- a systematic review and meta-analysis.

ABSTRACT:

Purpose

Intravenous maintenance fluid therapy (IV-MFT) prescribing in acute and critically ill children is very variable among pediatric health care professionals. In order to provide up to date IV-MFT guidelines, the European Society of Pediatric and Neonatal Intensive Care (ESPNIC) undertook a systematic review to answer the following five main questions about IV-MFT: (i) the indications for use (ii) the role of isotonic fluid (iii) the role of balanced solutions (iv) IV fluid composition (calcium, magnesium, potassium, glucose and micronutrients) and v) and the optimal amount of fluid.

Methods

A multidisciplinary expert group within ESPNIC conducted this systematic review using the Scottish Intercollegiate Guidelines Network (SIGN) grading method. Five databases were searched for studies that answered these questions, in acute and critically children (from 37 weeks gestational age to 18 years), published until November 2020. The quality of evidence and risk of bias were assessed, and meta-analyses were undertaken when appropriate. A series of recommendations was derived and voted on by the expert group to achieve consensus through two voting rounds.

Results

56 papers met the inclusion criteria, and 16 recommendations were produced. Outcome reporting was inconsistent among studies. Recommendations generated were based on a heterogeneous level of evidence, but consensus within the expert group was high. "Strong consensus" was reached for 11/16 (69%) and "consensus" for 5/16 (31%) of the recommendations.

Conclusions

Key recommendations are to use isotonic balanced solutions providing glucose to restrict IV-MFT infusion volumes in most hospitalized children and to regularly monitor plasma electrolyte levels, serum glucose and fluid balance.

SUBMITTER: Brossier DW

PROVIDER: S-EPMC9705511 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Publications

ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children- a systematic review and meta-analysis.

Brossier David W DW Tume Lyvonne N LN Briant Anais R AR Jotterand Chaparro Corinne C Moullet Clémence C Rooze Shancy S Verbruggen Sascha C A T SCAT Marino Luise V LV Alsohime Fahad F Beldjilali Sophie S Chiusolo Fabrizio F Costa Leonardo L Didier Capucine C Ilia Stavroula S Joram Nyandat L NL Kneyber Martin C J MCJ Kühlwein Eva E Lopez Jorge J López-Herce Jesus J Mayberry Huw F HF Mehmeti Fortesa F Mierzewska-Schmidt Magdalena M Miñambres Rodríguez Maria M Morice Claire C Pappachan John V JV Porcheret Florence F Reis Boto Leonor L Schlapbach Luregn J LJ Tekguc Hakan H Tziouvas Konstantinos K Parienti Jean-Jacques JJ Goyer Isabelle I Valla Frederic V FV

Intensive care medicine 20221026 12

<h4>Purpose</h4>Intravenous maintenance fluid therapy (IV-MFT) prescribing in acute and critically ill children is very variable among pediatric health care professionals. In order to provide up to date IV-MFT guidelines, the European Society of Pediatric and Neonatal Intensive Care (ESPNIC) undertook a systematic review to answer the following five main questions about IV-MFT: (i) the indications for use (ii) the role of isotonic fluid (iii) the role of balanced solutions (iv) IV fluid composit ...[more]

PMID: 36289081

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Dataset Information

ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children- a systematic review and meta-analysis.

Purpose

Methods

Results

Conclusions

Publications

ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children- a systematic review and meta-analysis.

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