title: Perioperative intravenous fluid therapy in children: guidelines from the Association of the Scientific Medical Societies in Germany.
abstract: This consensus- based S1 Guideline for perioperative infusion therapy in children is focused on safety and efficacy. The objective is to maintain or re-establish the child's normal physiological state (normovolemia, normal tissue perfusion, normal metabolic function, normal acid- base- electrolyte status). Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. A physiologically composed balanced isotonic electrolyte solution (BS) with 1-2.5% glucose is recommended for the intraoperative background infusion to maintain normal glucose concentrations and to avoid hyponatremia, hyperchloremia, and lipolysis. Additional BS without glucose can be used in patients with circulatory instability until the desired effect is achieved. The additional use of colloids (albumin, gelatin, hydroxyethyl starch) is recommended to recover normovolemia and to avoid fluid overload when crystalloids alone are not sufficient and blood products are not indicated. Monitoring should be extended in cases with major surgery, and autotransfusion maneuvers should be performed to assess fluid responsiveness.
authors.affiliation: Clinic for Anaesthesiology and Intensive Care Medicine, Hanover Medical School, Hanover, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Sümpelmann
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Cnopf'sche Kinderklinik/Klinik Hallerwiese, Nuremberg, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Becke
authors.affiliation: Department of Pediatric and Adolescent Medicine, University Hospital Dresden, Dresden, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Brenner
authors.affiliation: Department of Anesthesia, Klinikum Klagenfurt, Klagenfurt, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Breschan
authors.affiliation: Department of Anaesthesia, Paediatric Intensive Care and Emergency Medicine, Auf der Bult Children's Hospital, Hanover, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Eich
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Höhne
authors.affiliation: Section of Paediatric Anaesthesia, Department of Anaesthesia, Kantonsspital, Luzern, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Jöhr
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Klinikum Stuttgart, Olgahospital, Stuttgart, Germany.
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Kretz
authors.affiliation: Department of Intensive and Intermediate Care Medicine, University Hospital of RWTH Aachen, Aachen, Germany.
authors.forename: Gernot
authors.initials: G
authors.lastname: Marx
authors.affiliation: Department of Pediatric Kidney, Liver and Metabolic Diseases, Hanover Medical School, Hanover, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Pape
authors.affiliation: Department of Anesthesiology, Ulm University Medical Center, Ulm, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Schreiber
authors.affiliation: Clinic for Anesthesiology, Perioperative Medicine and Pain Therapy, HELIOS Klinikum Berlin Buch, Berlin, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Strauss
authors.affiliation: Department of Anesthesia, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Markus
authors.initials: M
authors.lastname: Weiss
mesh_terms: D002648:Child; D002675:Child, Preschool; D005440:Fluid Therapy / Q000379:methods*; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019990:Perioperative Care / Q000379:methods*; D012955:Societies, Medical
keywords: age; age, infant; age, neonate; fluids, child; fluids, colloids; fluids, salt solutions; salt solutions