title: Maintenance intravenous fluid prescribing practices among paediatric residents.
abstract: OBJECTIVE
  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.
authors: Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, PA 15224, USA.
authors: M A
authors: MA
authors: Freeman
authors: J C
authors: JC
authors: Ayus
authors: M L
authors: ML
authors: Moritz
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001127:Arginine Vasopressin / Q000097:blood*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005440:Fluid Therapy / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D007396:Internship and Residency; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D008581:Meningitis / Q000628:therapy; D010372:Pediatrics / Q000379:methods / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D012964:Sodium / Q000097:blood; D014481:United States
chemical_list: D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic; D001127:Arginine Vasopressin; D012964:Sodium