Current Thinking In Pediatric Peri-operative Fluid Therapy

Abstract

Proper perioperative fluid management is critical to maintain cardiovascular stability and adequate tissue perfusion. The volume and composition of fluid should be adapting to the physiology of the child and compensating for the peri-operative events.Traditionally physicians were calculating paediatric maintenance fluid requirements based on studies conducted on healthy children more than 50 years ago by Holliday et al.But a search of literature failed to reveal a relevant prospective study critically evaluating the content and volume of Holliday and Segar prescription. But off late there has been a major debate and re-evaluation about this concept because of serious concerns regarding development of hyponatraemia and hyperglycaemia. This can result in serious neurological damage or even death in a sick child. This brief review is an attempt to explain how the original concept was formed and what is the current thinking?