IV Fluid Update

Pediatric intensivist, Dr. Will Cagle joins the show to discuss the AAP Maintenance IV fluid guidelines and considerations when choosing IV fluids for pediatric inpatients.

What do you need to know from the 2018 AAP maintenance IV fluid guideline? 

How common is hyponatremia in hospitalized patients and why does it matter to your practice? 

What is SIADH and how does it contribute to hyponatremia in acutely ill children? 

How can we prevent hyponatremia in our hospitalized patients? 

What are the differences between hypotonic and isotonic fluids? 

What are balanced solutions and why might they be preferred as compared to saline in some clinical settings? 

All of this and more from the Department of Pediatrics and the Medical College of Georgia. 

Check out our website for detailed show-notes: https://www.augusta.edu/mcg/pediatrics/residency/podcast.php

Special thanks to Dr. Asif Mansuri and Dr. Gene Fisher for providing peer review for this episode.

Questions, comments, or feedback? Please email us at mcgpediatricpodcast@augusta.edu 

Want Further Reading? Check out the clinical practice guideline from the AAP and our other references below.

• Feld LG, Neuspiel DR, Foster BA, et al. Clinical Practice Guideline: Maintenance Intravenous Fluids in Children. Pediatrics. 2018;142(6):e20183083. doi:10.1542/peds.2018-3083 
• Semler MW, Self WH, Wanderer JP, et al. Balanced Crystalloids versus Saline in Critically Ill Adults. N Engl J Med. 2018;378(9):829-839. doi:10.1056/NEJMoa1711584 
• Cuzzo B, Padala SA, Lappin SL. Vasopressin (Antidiuretic Hormone, ADH) [Updated 2020 Apr 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526069/ 
• Chowdhury, Abeed H. BSc, MRCS*; Cox, Eleanor F. PhD†; Francis, Susan T. PhD†; Lobo, Dileep N. DM, FRCS, FACS* A Randomized, Controlled, Double-Blind Crossover Study on the Effects of 2-L Infusions of 0.9% Saline and Plasma-Lyte® 148 on Renal Blood Flow Velocity and Renal Cortical Tissue Perfusion in Healthy Volunteers, Annals of Surgery: July 2012 - Volume 256 - Issue 1 - p 18-24 doi: 10.1097/SLA.0b013e318256be72 
• Peti-Peterdi J, Harris RC. Macula densa sensing and signaling mechanisms of renin release. J Am Soc Nephrol. 2010;21(7):1093-1096. doi:10.1681/ASN.2009070759 

• Wilcox CS. Regulation of renal blood flow by plasma chloride. J Clin Invest. 1983;71(3):726-735. doi:10.1172/jci110820