Fluid and Electrolyte Therapy in Children

Somers, Michael J.

doi:10.1007/978-3-540-76341-3_13

Cited by 4 publications

(9 citation statements)

References 88 publications

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“…Another frequent incompatibility occurred between dimenhydrinate and a solution of potassium chloride 10% + sodium chloride 20% + glucose (33.77% of medical prescriptions). This solution is often prescribed for pediatric patients, for water replacement and/or maintenance and is used to maintain patients' body homeostasis while fasting, offering the necessary amount of water and electrolytes to restore the losses due to physiological processes, such as diuresis, sweating, bowel movements, and respiration 22 .…”

Section: Discussionmentioning

confidence: 99%

Potential Medication Incompatibilities In Pediatric Oncology Prescriptions

Santos

Rocha

Lopes

et al. 2023

CBR

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Introduction:Pediatric oncology patients have a limited number of venous access routes and need a large number of drugs during hospitalization. This study evaluates potential medication incompatibilities (MI) in pediatric oncology prescriptions and identifies possible factors associated with the risk of their occurrence. Methods:This cross-sectional study evaluated prescriptions from a tertiary universitary hospital from December 2014 to December 2015. The association between variables and the risk of potential incompatibilities between drugs was determined by Student's t-test and Pearson's chi-square, considering p < 0.05 significant. The odds ratio was calculated considering a 95% confidence interval for each drug.Results: 385 prescriptions were evaluated. The mean age of 124 patients was 9.22 years old (SD = ± 5.10), and 50.65% were male. The most frequent diagnosis and reason for hospitalization were leukemia (27.30%) and chemotherapy (36.10%). The totally implantable catheter was the most commonly used venous access (61.30%). In 87.5% of prescriptions, there was the possibility of MI, and 2108 incompatibilities were found, considering 300 different combinations between two drugs. Age, diagnosis, reason for hospitalization, and type of venous access were risk factors for potential incompatibilities (p < 0.05). The following drugs present higher risk of potential incompatibilities: leucovorin, sodium bicarbonate, cefepime, diphenhydramine, dimenhydrinate, hydrocortisone, and ondansetron, with a significant odds ratio. Conclusion:The possibility of MI in prescriptions for pediatric oncology patients is frequent. Thus, the identification of risk factors may contribute to patient safety and to the rational use of drugs.

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Section: Discussionmentioning

confidence: 99%

Potential Medication Incompatibilities In Pediatric Oncology Prescriptions

Santos

Rocha

Lopes

et al. 2023

CBR

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“…Fever increases insensible losses by more than 10% per degree Celsius rise in body temperature. 3 Premature babies with larger surface areas and on open warmers/ receiving phototherapy have 2-3 times greater insensible losses. Children on ventilators may have half insensible losses of a non-ventilated children.…”

Section: Insensible Losses In Acute Illnessesmentioning

confidence: 99%

“…The clinical situations in children requiring such therapy are myriad and range from urgent cases of circulatory collapse to more mundane cases of mild dehydration from gastroenteritis. 3 Dehydration in children due to diarrhea is common and has well-established guidelines. However, other common illnesses like fever, nausea, vomiting, heat exhaustion, viral diseases, and upper respiratory tract infection (URTIs) can cause overt or subclinical dehydration leading to fluid, electrolytes and energy (FEE) deficits in children; with general weakness depicted as a common symptom.…”

Section: Introductionmentioning

confidence: 99%

“…However, other common illnesses like fever, nausea, vomiting, heat exhaustion, viral diseases, and upper respiratory tract infection (URTIs) can cause overt or subclinical dehydration leading to fluid, electrolytes and energy (FEE) deficits in children; with general weakness depicted as a common symptom. [3][4][5][6] In 1957, Holliday and colleagues devised simplified equations to link average daily metabolic rate to daily fluid requirements for an ill child based on continuing/ "maintenance" needs, and past and current losses/ "deficits" was considered the gold standard to minimize complications and improve clinical outcomes. 7 In children requiring rehydration, a tradition of fluid therapy grounded on so-called "deficit therapy" approach became widespread.…”

Section: Introductionmentioning

confidence: 99%

“…8 Similarly, children with non-diarrheal illness, also need careful assessment and prescription of fluid and electrolyte therapy. 3 Most of the scientific evidence for oral FEE management for acute illnesses with dehydration has been extrapolated from diarrheal cases; even though, the requirements for non-diarrheal illnesses can be significantly different. In general, clinicians have strong awareness of the role of fluid and electrolytes in diarrhea.…”

Section: Introductionmentioning

confidence: 99%

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Role of Oral Fluid, Electrolytes and Energy in various pediatric illnesses beyondDiarrhea: An Indian Expert Panel Consensus Recommendation

Ghosh

Bavdekar²,

Wadhwa³

et al. 2022

Preprint

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Background: Dehydration in non-diarrheal illnesses often goes unnoticed and there are no consensus treatment recommendations for management of dehydration in non-diarrheal illnesses. Main Body: A multi-disciplinary committee of 10 experts from India gathered on a virtual advisory–board meeting on September 2020 to develop a consensus recommendation on current treatment strategies for managing oral fluid electrolyte and energy in pediatric patients during non-diarrheal illnesses and to identify unmet evidence-based needs and gaps. A pre-meeting questionnaire-based voting system was adopted to reach consensus followed by a discussion between panel members. In absence of consensus, the topic was opened for debate to arrive at an aligned recommendation. Key clinical challenges include identifying dehydration in acute illnesses and recommending appropriate quantity and type of oral fluids based on symptom severity. This consensus statement provides guidance on management of dehydration in non-diarrheal illnesses including recommendation on oral fluid, electrolyte and appropriate energy management in pediatric population.Conclusions: The group proposed the need for oral fluid, electrolyte and energy supplementation, which should be based on symptoms in acute non-diarrheal illness increased insensible losses and/or decreased intake. Oral rehydration fluids should be prescribed accurately and at the right-time for countering dehydration, ideally early in the course of illness. Prescribing pattern should be precise and similar to intravenous fluids. Carbonated drinks and canned juices should not be recommended. Plain water may not be optimal in replacing electrolytes especially for anorexic patients who can only tolerate fluids. These clinical practice statements provide guidance for oral fluid, electrolyte and energy recommendations for pediatric patients with various acute illnesses beyond diarrhea.

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Fluid and Electrolyte Balance in Infants and Children

Chukwu¹,

Molloy²

2016

Pediatric Surgery

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Fluid and Electrolyte Therapy in Children

Cited by 4 publications

References 88 publications

Potential Medication Incompatibilities In Pediatric Oncology Prescriptions

Potential Medication Incompatibilities In Pediatric Oncology Prescriptions

Role of Oral Fluid, Electrolytes and Energy in various pediatric illnesses beyondDiarrhea: An Indian Expert Panel Consensus Recommendation

Fluid and Electrolyte Balance in Infants and Children

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