A Consensus Recommendation for Pediatric Intravenous Maintenance Fluid in Belgium: On Behalf of the Be-PIV Group

Abstract

Prescribing intravenous maintenance fluids is a daily practice for pediatricians worldwide. Failing to administer the correct fluid type or rate can impact morbidity and mortality. Nevertheless, different regimens are being used based on old guidelines. This narrative review aims to formulate a guideline for the Belgian clinician. We screened databases for manuscripts on pediatric intravenous maintenance fluid therapy. Studies were evaluated on seven relevant topics, and our expert group discussed, formulated, and reviewed recommendations, leading to a guideline for hospitalized children outside the neonatal period. We recommend using isotonic, preferably balanced, solutions with glucose 5 g/L and potassium 20 mEq/L with a restricted rate in most hospitalized children. Our guideline also provides work-up and daily monitoring recommendations to avoid complications during maintenance therapy. Specific situations or comorbidities may warrant a tailored approach, as shown in the proposed algorithm.