Intravenous postoperative fluid prescriptions for children: a survey of practice.
BACKGROUND
Postoperative deaths and neurological injury have resulted from hyponatraemia associated with the use of hypotonic saline solutions following surgery. We aimed to determine the rates and types of intravenous fluids being prescribed postoperatively for children in the UK.


METHODS
A questionnaire was sent to members of the British Association of Paediatric Surgeons (BAPS) and Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) based at UK paediatric centres. Respondents were asked to prescribe postoperative fluids for scenarios involving children of different ages. The study period was between May 2006 and November 2006.


RESULTS
The most frequently used solution was sodium chloride 0.45% with glucose 5% although one quarter of respondents still used sodium chloride 0.18% with glucose 4%. Isotonic fluids were used by 41% of anaesthetists and 9.8% of surgeons for the older child, but fewer for infants. Standard maintenance rates or greater were prescribed by over 80% of respondents.


CONCLUSIONS
Most doctors said they would prescribe hypotonic fluids at volumes equal to or greater than traditional maintenance rates at the time of the survey. A survey to describe practice since publication of National Patient Safety Agency (NPSA) recommendations is required.
Department of Paediatric Surgery, John Radcliffe Hospital, Oxford, UK. polly.davies@ngh.nhs.uk
Polly
P
Davies
Tim
T
Hall
Tariq
T
Ali
Kokila
K
Lakhoo
D001062:Appendectomy; D002648:Child; D003560:Cysts / Q000601:surgery; D004334:Drug Administration Schedule; D054796:Drug Dosage Calculations; D004573:Electrolytes / Q000008:administration & dosage / Q000493:pharmacokinetics; D005440:Fluid Therapy / Q000145:classification* / Q000706:statistics & numerical data*; D005767:Gastrointestinal Diseases / Q000601:surgery; D005947:Glucose / Q000008:administration & dosage; D019538:Health Care Surveys; D006801:Humans; D007003:Hypoglycemia / Q000628:therapy; D007010:Hyponatremia / Q000139:chemically induced; D007038:Hypotonic Solutions / Q000008:administration & dosage* / Q000009:adverse effects / Q000145:classification; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007443:Intussusception / Q000601:surgery; D007552:Isotonic Solutions / Q000008:administration & dosage; D007813:Laparotomy; D008508:Medication Errors / Q000706:statistics & numerical data; D008991:Monitoring, Physiologic; D011182:Postoperative Care / Q000145:classification* / Q000706:statistics & numerical data*; D055656:Prescriptions / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
D004573:Electrolytes; D007038:Hypotonic Solutions; D007552:Isotonic Solutions; D005947:Glucose