AAP guideline 2018 recommends isotonic IV fluids for most ch
In a recently released evidence-based guideline, the AAP (American Academy of Pediatrics) recommends isotonic intravenous fluids (IVFs) with appropriate potassium chloride and dextrose for most children aged 28 days to 18 years who require maintenance IVFs. The guideline has been published in the journal Pediatrics.

Maintenance intravenous fluids (IVFs) are used to provide critical supportive care for children who are acutely ill. IVFs are required if sufficient fluids cannot be provided by using enteral administration for reasons such as gastrointestinal illness, respiratory compromise, neurologic impairment, a perioperative state, or being moribund from an acute or chronic illness.

The guideline specifically addresses the tonicity of maintenance IVFs and is applicable to children in surgical (postoperative) and medical acute-care settings, including critical care and the general inpatient ward.

Patients in the following category are excluded:-
• Neurosurgical disorders
• Congenital or acquired cardiac disease
• Hepatic disease
• Cancer
• Renal dysfunction
• Diabetes insipidus
• Voluminous watery diarrhea, or severe burns
• Neonates who are younger than 28 days old or in the NICU
• Adolescents older than 18 years old

The Key Action Statement is (evidence quality: A; recommendation strength: strong) :-
"The American Academy of Pediatrics recommends that patients 28 days to 18 years of age requiring maintenance IVFs should receive isotonic solutions with appropriate potassium chloride and dextrose because they significantly decrease the risk of developing hyponatremia"

About AAP
The American Academy of Pediatrics (AAP) is an American professional association of paediatricians. It is an organization of 67,000 paediatricians committed to the optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults.

Note: This list is a brief compilation of some of the key points included in the guideline and is not exhaustive and does not constitute medical advice. Kindly refer to the original publication here: http://pediatrics.aappublications.org/content/early/2018/11/21/peds.2018-3083
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