GULHANE MEDICAL JOURNAL 2019 , Vol 61 , Issue 2
Perioperative fluid management in pediatric patients
Mehmet Burak Eşkin1,Mehmet Emin Orhan1
1University of Health Sciences, Gulhane Medical School, Anesthesiology and Reanimation, Ankara, Turkey DOI : 10.26657/gulhane.00059 Perioperative fluid management is the application to prevent changes in the fluid compartments that may arise from surgery and anesthesia and the related electrolyte disorders. The aim is to provide adequate tissue perfusion in the perioperative period. Since even minor changes in fluid compartments in pediatric patients may affect physiological functions, it requires more importance compared to fluid management in adults. In this paper, it is aimed to update the knowledge about perioperative fluid treatment in pediatric patients, in accordance with the literature. According to recent studies, fasting times in the preoperative period should be reduced to 1 hour for clear fluids. Clinical protocols for oral fluids should be established in the perioperative period The Holiday-Segar formula (4/2/1), which was developed in 1957 according to caloric requirements in intraoperative fluid replacement, is still widely used. On the other hand, it is apparent that hyponatremia and hyperglycemia have a high risk of hypotonic fluid containing dextrose, according to this formula. It is not appropriate to use dextrose-containing fluids in children older than 4 weeks in the intraoperative period. If there is no contraindication in the postoperative period, enteral fluid intake must be started as soon as possible. In children with enteral feeding contraindicated, 5% glucose-containing fluids for children younger than 6 years of age, isotonic fluids containing 2% glucose with isotonic fluids for children older than 6 should be used as a postoperative maintenance fluid. Monitoring of fluid and electrolytes must be performed during the perioperative period of major surgical procedures. Keywords : Pediatric Anesthesia, Fluid Management, hyperglycemia, hyponatremia