Article Text

Download PDFPDF
QUESTION 2: Are intravenous fluid boluses beneficial in late preterm or term infants with suspected haemodynamic compromise?
  1. Amy Keir,
  2. Bernd Froessler,
  3. Simon Stanworth
  1. Robinson Research Institute, School of Medicine, University of Adelaide, South Australia, Australia
  1. Correspondence to Dr Amy Keir, Department of Neonatal Medicine, Level 1 Zone F (Queen Victoria Building), Women's and Children's Hospital Campus, 72 King William Road, North Adelaide, SA 5006, Australia; amy.keir{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


An infant at 38 weeks was delivered 1 h ago and did not require any resuscitation at delivery. There is no history of placental abruption or fetomaternal haemorrhage. Her cord gas pH was 7.3. She is vigorous but pale with a delayed capillary refill time (>3 s) and the resident has admitted her to the nursery. A venous blood gas is done, which reveals a normal haemoglobin value and a metabolic acidosis (pH 7.2 and a base excess of −11) with an elevated lactate (6 mmol/L). The neonatologist on duty requests a fluid bolus is given to ‘treat the acidosis’. You wonder as to the value of this seemingly routine invention in your nursery.

Structured clinical question

In a late preterm or term infant with signs of haemodynamic compromise with diverse underlying clinical conditions (excluding acute haemorrhage) [patient] does an initial fluid bolus (10 mL/kg) [intervention] compared with no fluid bolus [comparison] provide any objective clinical benefit? [outcome].

Haemodynamic compromise was defined as hypotension, lactic acidosis, other metabolic acidosis, poor perfusion as assessed clinically, abnormal gas exchange or combinations …

View Full Text


  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Linked Articles