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
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- EP ID EP335804
- DOI 10.21304/2017.0403.00189
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