Perioperative intravenous fluid therapy in children: guidelines from the Association of the Scientific Medical Societies in Germany

• DOI: 10.1111/pan.13007
• Publication Date: 2016-10-17T07:26:59Z
• Authors: Robert Sümpelmann; Karin Becke; Sebastian Brenner; Christian Breschan; Christoph Eich; Claudia Höhne; Martin Jöhr; Franz‐Josef Kretz; Gernot Marx; Lars Pape; Markus Schreiber; Jochen Strauss; Markus Weiss
• Keywords: Infant, Newborn; Infant; 610 Medicine & health; Perioperative Care; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Child, Preschool; Germany; Fluid Therapy; Humans; 10220 Clinic for Surgery; 2735 Pediatrics, Perinatology and Child Health; 2703 Anesthesiology and Pain Medicine; Child; Societies, Medical

SummaryThis 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.