Advertisement

Fluid and Electrolyte Balance in Infants and Children

  • Joseph ChukwuEmail author
  • Eleanor Molloy
Living reference work entry
  • 431 Downloads

Abstract

During the time of rapid postnatal transition, for example, term and preterm neonates have different fluid requirements and electrolyte changes to the older children and adults (Table 1). Age and gender are the most important determinants of this wide variation in fluid and electrolyte requirements (Bianchetti and Simonetti 2009). Knowledge of the fluid and electrolyte composition and maintenance of homeostasis maintained at the different stages of infancy and childhood is essential to the effective management of fluid and electrolyte deficit in surgical pediatric patients.

Keywords

Fluid balance Electrolyte balance Acid-base balance Dehydration Osmolality Perioperative management 

References

  1. Agus MS, Agus ZS. Cardiovascular actions of magnesium. Crit Care Clin. 2001;17(1):175–86.CrossRefPubMedGoogle Scholar
  2. Ahee P, Crowe AV. The management of hyperkalaemia in the emergency department. J Accid Emerg Med. 2000;17:188–91.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Allen M. Lactate and acid base as a hemodynamic monitor and markers of cellular perfusion. Pediatr Crit Care Med. 2011;12(4 Suppl):S43–9.CrossRefPubMedGoogle Scholar
  4. Aneja R, Carcillo J. Differences between adult and pediatric septic shock. Minerva Anestesiol. 2011;77(10):986–92.PubMedGoogle Scholar
  5. Askegard-Giesmann JR, Kenney BD. Controversies in nutritional support for critically ill children. Semin Pediatr Surg 2015;24(1):20–4.Google Scholar
  6. Ayuk J, Gittoes NJ. How should hypomagnesaemia be investigated and treated? Clin Endocrinol. 2011;75(6):743–6.CrossRefGoogle Scholar
  7. Bailey B, Gravel J, Goldman RD, Friedman JN, Parkin PC. External validation of the clinical dehydration scale for children with acute gastroenteritis. Acad Emerg Med. 2010;17(6):583–8.CrossRefPubMedGoogle Scholar
  8. Becker J, Friedman E. Renal function status. AJR Am J Roentgenol. 2013;200(4):827–9.CrossRefPubMedGoogle Scholar
  9. Bianchetti MG, Simonetti GD, Bettinelli A. Body fluids and salt metabolism – part I. Ital J Pediatr. 2009;35(1):36.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Brandis, K. Regulation of cell volume. Fluid Physiol. 2001. http://www.anaesthesiamcq.com/FluidBook/fl6_2.php
  11. Bullock J, Boyle III J, Wang M, editors. NMS physiology. 4th ed. Baltimore: Lippincott Williams & Wilkins; 2001.Google Scholar
  12. Carcillo JA, Kuch BA, Han Y, et al. Mortality and functional morbidity after use of PALS/APLS by community physicians. Pediatrics. 2009;124:500–8.CrossRefPubMedGoogle Scholar
  13. Carter ER, Marshall SG. Cystic fibrosis. In: Marcdante KJ, Kliegman RM, Jenson HB, et al., editors. Nelson essentials of pediatrics. 6th ed. Philadelphia: Saunders Elsevier; 2010. p. 521–2.Google Scholar
  14. Cheung M. Drugs used in paediatric bone and calcium disorders. Endocr Dev. 2009;16:218–32.CrossRefPubMedGoogle Scholar
  15. Copeman MC. Use of total parenteral nutrition in children with cancer: a review and some recommendations. Pediatr Hematol Oncol. 1994;11(5):463–70.CrossRefPubMedGoogle Scholar
  16. Covic A, Rastogi A. Hyperphosphatemia in patients with ESRD: assessing the current evidence linking outcomes with treatment adherence. BMC Nephrol. 2013;14:153.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Davies JH. A practical approach to problems of hypercalcaemia. Endocr Dev. 2009;16:93–114.CrossRefPubMedGoogle Scholar
  18. Fang C, Mao J, Dai Y, et al. Fluid management of hypernatraemic dehydration to prevent cerebral oedema: a retrospective case control study of 97 children in China. J Paediatr Child Health. 2010;46(6):301–3.CrossRefPubMedGoogle Scholar
  19. Filston HC, Edwards 3rd CH, Chitwood Jr WR, Larson RM, Marsicano TH, Hill RC. Estimation of postoperative fluid requirements in infants and children. Ann Surg. 1982;196(1):76–81.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Foglia PE, Bettinelli A, Tosetto C, Cortesi C, Crosazzo L, Edefonti A, Bianchetti MG. Cardiac work up in primary renal hypokalaemia-hypomagnesaemia (Gitelman syndrome). Nephrol Dial Transplant. 2004;19(6):1398–402.CrossRefPubMedGoogle Scholar
  21. Ford D. Fluid, electrolyte, & acid-base disorders & therapy. In: Hay Jr W, Hayward A, Levin M, Sondheimer J, editors. Current pediatric diagnosis & treatment. 16th ed. New York: Lange Medical/McGraw-Hill; 2002. p. 1280–8.Google Scholar
  22. Forman S, Crofton P, Huang H, Marshall T, Fares K, McIntosh N. The epidemiology of hypernatraemia in hospitalised children in Lothian: a 10-year study showing differences between dehydration, osmoregulatory dysfunction and salt poisoning. Arch Dis Child. 2012;97(6):502–7.CrossRefPubMedGoogle Scholar
  23. Friedman JN, Goldman RD, Srivastava R, Parkin PC. Development of a clinical dehydration scale for use in children between 1 and 36 months of age. J Pediatr. 2004;145(2):201–7.CrossRefPubMedGoogle Scholar
  24. Gambling DR, Birmingham CL, Jenkins LC. Magnesium and the anaesthetist. Can J Anaesth. 1988;35(6):644–54.CrossRefPubMedGoogle Scholar
  25. Goldman RD, Friedman JN, Parkin PC. Validation of the clinical dehydration scale for children with acute gastroenteritis. Pediatrics. 2008;122(3):545–9.CrossRefPubMedGoogle Scholar
  26. Gonzalez EP, Santos F, Coto E. Magnesium homeostasis. Etiopathogeny, clinical diagnosis and treatment of hypomagnesaemia. A case study. Nefrologia. 2009;29(6):518–24.PubMedGoogle Scholar
  27. Greenbaum L. Acid-base disorders. In: Marcdante KJ, Kliegman RM, Jenson HB, et al., editors. Nelson essentials of pediatrics. 6th ed. Philadelphia: Saunders Elsevier; 2010a. p. 136–40.Google Scholar
  28. Greenbaum L. Fluids and electrolytes. In: Marcdante KJ, Kliegman RM, Jenson HB, et al., editors. Nelson essentials of pediatrics. 6th ed. Philadelphia: Saunders Elsevier; 2010b. p. 123–5.Google Scholar
  29. Greenbaum L. Potassium disorders. In: Marcdante KJ, Kliegman RM, Jenson HB, et al., editors. Nelson essentials of pediatrics. 6th ed. Philadelphia: Saunders Elsevier; 2010c.Google Scholar
  30. Greenlee M, Wingo CS, McDonough AA, Youn JH, Kone BC. Narrative review: evolving concepts in potassium homeostasis and hypokalemia. Ann Intern Med. 2009;150:619–25.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Hoorn EJ, Tuut MK, Hoorntje SJ, van Saase JL, Zietse R, Geers AB. Dutch guideline for the management of electrolyte disorders – 2012 revision. Neth J Med. 2012;71(3):153–65.Google Scholar
  32. Jain VV, Gupta OP, Jajoo SU, Khiangate B. Hypokalemia induced rhabdomyolysis. Indian J Nephrol. 2011;21(1):66.CrossRefPubMedPubMedCentralGoogle Scholar
  33. Kocoshis SA. Medical management of pediatric intestinal failure. Semin Pediatr Surg. 2010;19(1):20–6.CrossRefPubMedGoogle Scholar
  34. Kraus DM. Pediatrics nutrition. PMPR 652 Pharmacoceutics II. 1998. Retrieved from www.uic.edu website: http://www.uic.edu/classes/pmpr/pmpr652/Final/krauss/pedsnutrition.html.
  35. Lietman SA, Germain-Lee EL, Levine MA. Hypercalcemia in children and adolescents. Curr Opin Pediatr. 2010;22(4):508–15.CrossRefPubMedPubMedCentralGoogle Scholar
  36. Lum GM. Kidney and urinary tract. In: Hay Jr W, Hayward A, Levin M, Sondheimer J, editors. Current pediatric diagnosis & treatment. 16th ed. New York: Lange Medical/McGraw-Hill; 2002. p. 693–716.Google Scholar
  37. MacLaren G, Butt W, Best D, Donath S. Central extracorporeal membrane oxygenation for refractory pediatric septic shock. Pediatr Crit Care Med. 2011;12(2):133–6.CrossRefPubMedGoogle Scholar
  38. Mahan JD. Nephrology and urology. In: Marcdante KJ, Kliegman RM, Jenson HB, et al., editors. Nelson essentials of pediatrics. 6th ed. Philadelphia: Saunders Elsevier; 2010. p. 607–10.Google Scholar
  39. Maitlan K, Kiguli S, Opoka RO, et al. FEAST trial group. Mortality after fluid bolus in African children with severe infection. N Engl J Med. 2011;364(26):2483–95.CrossRefGoogle Scholar
  40. Marini JJ, Wheeler AP, editors. Critical care medicine – the essential. 4th ed. Philadelphia: Lippinkott Williams and Wilkins; 2010.Google Scholar
  41. Melbourne, The Royal Children’s Hospital. Intravenous fluids: IV fluids for children beyond the neonatal period. 2012. Retrieved 03/07/2013, from http://www.rch.org.au/clinicalguide/guideline_index/Intravenous_Fluids/.
  42. Murdoch IA, Dos Anjos R, Haycock GB. Treatment of hyperkalaemia with intravenous salbutamol. Arch Dis Child. 1991;66(4):527–8.CrossRefPubMedPubMedCentralGoogle Scholar
  43. Ohlsson A, Hosking M. Complications following oral administration of exchange resins in extremely low-birth-weight infants. Eur J Pediatr. 1987;146(6):571–4.CrossRefPubMedGoogle Scholar
  44. Patel S. Sodium balance-an integrated physiological model and novel approach. Saudi J Kidney Dis Transpl. 2009;20(4):560–9.PubMedGoogle Scholar
  45. Peruzzo M, Milani GP, Garzoni L, et al. Body fluids and salt metabolism – part II. Ital J Pediatr. 2010;36(1):78.CrossRefPubMedPubMedCentralGoogle Scholar
  46. Robertson G, Carrihill M, Hatherill M, Waggie Z, Reynolds L, Argent A. Relationship between fluid management, changes in serum sodium and outcome in hypernatraemia associated with gastroenteritis. J Paediatr Child Health. 2007;43(4):291–6.CrossRefPubMedGoogle Scholar
  47. Samsonov D. Abnormalities in magnesium metabolism. In: Kiessling S, Goebel J, Somers M, editors. Pediatric nephrology in the ICU. Berlin: Springer; 2009. p. 69–84.CrossRefGoogle Scholar
  48. Sargent JT, Smith OP. Haematological emergencies managing hypercalcaemia in adults and children with haematological disorders. Br J Haematol. 2010;149(4):465–77.CrossRefPubMedGoogle Scholar
  49. Skorecki KL, Brenner BM. Body fluid homeostasis in man. A contemporary overview. Am J Med. 1981;70(1):77–88.CrossRefPubMedGoogle Scholar
  50. Somers M. Fluids and electrolyte therapy in children. In: Avner E, Harmon W, Niaudet P, Yoshikawa N, editors. Pediatric nephrology. 5th ed. Berlin: Springer; 2009. p. 325–53.CrossRefGoogle Scholar
  51. Steurer MA, Berger TM. Infusion therapy for neonates, infants and children. Anaesthesist. 2011;60(1):10–22.CrossRefPubMedGoogle Scholar
  52. Sumpelmann R, Becke K, Crean P, Johr M, Lonnqvist PA, Strauss JM, Veyckemans F. European consensus statement for intraoperative fluid therapy in children. Eur J Anaesthesiol. 2011;28(9):637–9.CrossRefPubMedGoogle Scholar
  53. Tran HA. Extreme hyperkalaemia. South Med J. 2005;98(7):729–32.CrossRefPubMedGoogle Scholar
  54. Troung TR, Grant R, Langlois V. Renal complications. In: Abla O, editor. Handbook of supportive care in pediatric oncology. 1st ed. Toronto: Jones and Bartlett; 2010. p. 267–88.Google Scholar
  55. Vemgal P, Ohlsson A. Interventions for non-oliguric hyperkalaemia in preterm neonates. Cochrane Database Syst Rev. 2012;5:CD005257.Google Scholar
  56. Vogt B, Berwert L, Burnier B. Hypernatremia. Ther Umsch. 2009;66(11):753–7.CrossRefPubMedGoogle Scholar
  57. Vretzakis G, Kleitsaki A, Aretha D, Karanikolas M. Management of intraoperative fluid balance and blood conservation techniques in adult cardiac surgery. Heart Surg Forum. 2011;14(1):E28–39.CrossRefPubMedGoogle Scholar
  58. Woolley WL, Burton JH. Pediatric acute gastroenteritis: clinical assessment, oral rehydration and antiemetic therapy. Pediatr Health. 2009;3(2):191–7.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2016

Authors and Affiliations

  1. 1.Clinical Research Unit, National Children’s Research CentreOur Lady’s Children’s HospitalDublin 12Ireland
  2. 2.Department of Neonatology, PaediatricsNational Maternity HospitalDublin 2Ireland
  3. 3.UCD School of Medicine and Medical SciencesUniversity College DublinDublinIreland
  4. 4.NeonatologyOur Lady’s Children’s HospitalDublin 12Ireland
  5. 5.PaediatricsRoyal College of Surgeons in IrelandDublinIreland

Personalised recommendations