Maintenance intravenous fluid prescribing practices among paediatric residents

Michael Freeman, J. C. Ayus, M. L. Moritz

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Aim: 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.

Original languageEnglish (US)
JournalActa Paediatrica, International Journal of Paediatrics
Volume101
Issue number10
DOIs
StatePublished - Oct 1 2012

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Maintenance
Pediatrics
Arginine Vasopressin
Meningitis
Internship and Residency
Gastroenteritis
Pneumonia
Sodium
Population

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

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abstract = "Aim: 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.",
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Maintenance intravenous fluid prescribing practices among paediatric residents. / Freeman, Michael; Ayus, J. C.; Moritz, M. L.

In: Acta Paediatrica, International Journal of Paediatrics, Vol. 101, No. 10, 01.10.2012.

Research output: Contribution to journalArticle

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