Fluid therapy in mechanically ventilated critically ill children - PMC
| Fluid Type | Best Use | Cautions | | :--- | :--- | :--- | | | First-line for resuscitation, replacement, and maintenance in most patients. LR is preferred for metabolic acidosis; saline for hypochloremic metabolic alkalosis or brain injury. | Large volumes of saline can cause hyperchloremic acidosis. | | Balanced Solutions (Plasma-Lyte, Normosol) | Ideal for sick patients with acid-base disorders, liver failure, or renal disease. More physiologic than saline. | Slightly more expensive than saline, but worth it in critical cases. | | Synthetic Colloids (Hydroxyethyl starch) | Rarely indicated. High risk of acute kidney injury and coagulopathy. Avoid in sepsis, burns, or renal failure. | For most veterinarians and physicians, it's best to keep colloids in the cabinet. | | Blood Products | For anemia with active bleeding or coagulopathy. | Requires cross-matching and slow administration. | Practical Guidelines on Fluid Therapy -Dr.Faruki-
You cannot just "set and forget" the IV pump. You must monitor. Forget the fancy monitors if you don't have them. Use your hands and eyes. | | Balanced Solutions (Plasma-Lyte, Normosol) | Ideal
— Dr. Faruki
Before you hang a bag of IV fluid, ask these 5 questions: | | Synthetic Colloids (Hydroxyethyl starch) | Rarely
