[Reappraisal of perioperative fluid therapy in children].
Two recently recognized issues are reviewed ; one is a hospital acquired hyponatremia in children treated with intravenous hypotonic maintenance fluids and the other is the pros and cons of glucose addition to these fluids. Children in the perioperative period are at risk for nonosmotic secretion of ADH and stress-induced insulin resistance, which necessitate reducing the volume of maintenance fluid to half the previously recommended volume, and the concentration of additive glucose to approximately 2%. While isotonic fluids are recommended intraoperatively, controversies still exist on the constitution of maintenance fluids in the postoperative period, where the choice of an isotonic solution should be more pertinent to that of a hypotonic solution, but evidence is weak ; further investigations are needed to make a decision.
Okabe
Yugo
Y
Department of Anesthesia, Faculty of Medicine, Kagawa University Kagawa 761-0793.
Maekawa
Nobuhiro
N
D002648:Child; D005440:Fluid Therapy; D005950:Glucose Solution, Hypertonic / Q000008:administration & dosage; D006801:Humans; D007038:Hypotonic Solutions / Q000008:administration & dosage; D007552:Isotonic Solutions / Q000008:administration & dosage; D019990:Perioperative Care; D000077331:Ringer's Solution
D005950:Glucose Solution, Hypertonic; D007038:Hypotonic Solutions; D007552:Isotonic Solutions; D000077331:Ringer's Solution