Methods: A multidisciplinary expert group within ESPNIC conducted this systematic review using the SIGN grading method. Five databases were searched for studies that answered these questions, in acute and critically children (from 37 weeks gestational age to 18 years), published until November 2020. The quality of evidence and risk of bias were assessed, and meta-analyses were undertaken when appropriate. A series of recommendations was derived and voted on by the expert group to achieve consensus through two voting rounds.
Results: 56 papers met the inclusion criteria, and 16 recommendations were produced. Outcome reporting was inconsistent among studies. Recommendations generated were based on a heterogeneous level of evidence, but consensus within the expert group was high. “Strong consensus” was reached for 11/16 (69%) and “consensus” for 5/16 (31%) of the recommendations.
Conclusions: Key recommendations are to use isotonic balanced solutions providing glucose, to restrict IV-MFT infusion volumes in most hospitalized children and to regularly monitor plasma electrolyte levels, serum glucose and fluid balance.
- Isotonic fluids
- balanced fluids
- fluid balance
- intensive care
- acutely ill children
- Health Research Institute
- Cardio-Respiratory Research Centre
- Children & Young People Research Network