1204 Which Fluid to Use in Pediatric Resuscitation… Still An Unanswered Question?

Abstract

Background and aims: The type of fluid used for resuscitation of patients with shock is subject to ongoing debate. This study was done to determine types of fluids used during resuscitation prior to admission to St Mary's PICU and to compare laboratory parameters before and after receiving these fluids.

Material and Methods: Patients were divided into three main groups.

Group I recieved only Normal Saline as their resuscitation fluid.

Group IIa received NS as their main resuscitation fluid whereas and any other fluids (e.g. packed cells, Fresh Frozen Plasma, platelets, 5% Human Albumin Solution, Gelofusin etc), comprised < 50% of total volume received.

Group IIb received any other fluids >/= 50% of total volume.

Results: 73 patients with shock were included in the study with mean age of 6.5 yrs. Sepsis was the main diagnosis. 43 children in Group I had significant fall in post resuscitation hemoglobin (p 0.0003), packed cell volume (PCV, p 0.0077), Potassium(p 0.0023) and albumin (p0.0009) with increase in chloride (p0.0048) and pH (p 0.0026).15 children in Group IIa showed significant fall in chloride (p0.0063) with only borderline fall in PCV (p0.054).15 children in groupIIb had significant fall in potassium (p0.0018).

Conclusions: Our study showed that children who received primarily normal saline had significant changes in important clinical and laboratory markers, this may have clinical significance. Current understanding of the advantages and limitations associated with different resuscitation fluids remains far from complete. Further studies are needed to address unresolved issues in fluid management in children with shock.

Figure

Table 2

Table 1 [Group I- only NS Gp. 43 patients]

Table 3

Table 2 [Group IIa- Mainly NS gp. (i.e other fluid)]

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