Maintenance Fluids in Resuscitation: 2018 Pediatric Surgery Practice Gap #4
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Key Takeaways
- Continue isotonic fluids during maintenance phase instead of switching to hypotonic solutions after resuscitation.
- Isotonic maintenance fluids decrease hyponatremia risk without adverse consequences compared to traditional hypotonic fluids.
- Despite evidence supporting isotonic maintenance fluids, many practitioners still order hypotonic fluids out of habit.
- Traditional teaching to switch from normal saline/LR to half-normal or quarter-normal saline is now outdated practice.
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Join us as we continue our review of the top 10 practice gaps of 2018, first presented at last year's update course by Apsa's practice Development Committee. Number four, Alex. So, number four addresses maintenance fluids and resuscitation. Before, the dogma was, you switch from isotonic to hypotonic once you reach maintenance phase. The new information is that you should continue with isotonic fluids. Because this decreases the risk of hyponatremia without any adverse consequences. So, I thought this was huge. I don't know what you guys thought. I have always been trained start with normal saline or LR and then switch to half normal saline or quarter normal saline. That's the way I've been taught. This whole idea of keeping them on isotonic fluid was a complete new thing to me. What about you guys? It is, it is very practice changing and at the same time, we have the data, there evidences there and most people are still reluctant to do this. I still see a lot of people ordering hypotonic fluids on the floor. Okay.