An Audit of Use of Maintenance Intravenous Fluid in Children Presenting in Pediatric Emergency Room of a Developing Country
Journal Title: Journal Of Pediatric Critical Care - Year 2017, Vol 4, Issue 3
Abstract
Objective: Maintenance intravenous fluid (mIVF) is cornerstone in the management of ill children. Several brain damage and mortalities in previously healthy children have been reported from traditional hypotonic fluid due to “hospital-acquired hyponatremia”. Purpose of this study is to assess the clinical practice in our pediatric emergency about mIVF. Material and Methods: Our study was conducted in the pediatric emergency room of a tertiary-care hospital in Karachi, Pakistan as a retrospective chart review. All children from 6months to 16 years of age, presented in the emergency room and required maintenance intravenous fluid therapy were included in the study. No intervention was done. Duration of this study was 3 months (April –July 2014) and was reviewed after ERC approval.All children from 6months to 16 years of age, required maintenance intravenous fluid therapy were included in the study. Primary outcome was the type of fluid prescribed as mIVF while secondary outcome was the difference of serum sodium level after 12-24hr. Results: 527 children were admitted, of those more than half (56%) were male. Median age was 43 months. Admitted patients in emergency were given three types of mIVF. Some children received all three types and some received only one. Most of the given IVF was IVF 0.9% i.e. 78.4% where as 31.7% received IVF 0.45% and only few received IVF 0.18%. Serum sodium of all patients was checked however only 22% were evaluated twice for serum sodium level. The mean sodium values were 135.6 and 137.7 for Na (0) and Na (1) respectively and mean difference between both Na was -0.97. No changes in Na (0) to Na (1) were reported in 9.6%. Conclusion: Isotonic fluid is better than hypotonic fluids in hospitalized children to prevent changes in serum sodium levels specially hyponatremia which results in morbidity as well as mortality.
Authors and Affiliations
Sayyeda Ghazala Irfan Kazi, Sidra Kaleem Jafri, Humaira Jurair
Keywords
Related Articles
- EP ID EP335804
- DOI 10.21304/2017.0403.00189
- Views 94
- Downloads 0
The profile of Invasive Pneumococcal disease in a Tertiary care PICU
.
Simulathon - Pediatric Trauma simulation training in-situ across India
.
Severe Tracheobronchitis associated with Disseminated Varicella in an Immunocompromised Child
Childhood chickenpox is usually a benign infection with mortality rate in healthy children aged 1-14 years is around 2 deaths per 100,000 cases. Among children with leukaemia mortality rate of varicella is up to 55%. We...
A case report of Conjoined Twin(PYGOPAGUS) separation
We report successful separation of PYGOPAGUS twins. Meticulous planning and multidisciplinary approach are the core aspects in the management of Pygopagus conjoined twins. Early elective separation versus delayed separat...
A review of role and use of catecholamines during critical illness in children
There is no fi rm evidence that any one catecholamine is more effective or safer than other in the treatment of shock. The choice of an agent depends on the underlying hemodynamic state. Understanding the pathophysiology...