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Fluid creep

There are three indications for prescription of intravenous fluids; fluid resuscitation, fluid replacement and fluid maintenance. Langer T et al. [BMC Pediatr 2020;20:424–411. https://doi.org/10.1186/s12887-020-02322-3] have examined another source of water, sodium and chloride load in children on Paediatric Intensive Care Units(PICU), that of ‘Fluid creep’. This can represent a substantial water and electrolyte amount, which is administered to patients as a vehicle for intravenous drugs, to provide patency of indwelling vascular catheters and to flush venous lines after blood withdrawal or drug administration. This was a retrospective review of only 43 children in a single centre PICU in Italy, but the message is clear and well written. Children aged ≤3 years and invasively ventilated for ≥48 hour between 2016 and 2019 were included in the study. They reviewed the quantity, quality and indication of fluids administered intravenously or enterally, urinary output and fluid balance were recorded for the first 48 hours following intubation. Patients received 1004±284 mL of water daily (153±36 mL/kg/day), mainly due to enteral (39%), fluid creep (34%) and maintenance (24%) fluids. The majority of sodium and chloride was derived from fluid creep (56% and 58%). Daily fluid balance was 417±221 mL (64±30 mL/kg/day) and was associated with total sodium intake (r2=0.49, p<0.001). …

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Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Data availability statement No data are available. data are not available.

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