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Fluid management practices after surgery for congenital heart disease: A worldwide survey

Hanot J et al
2 December, 2019  

Fluid overload in paediatric postoperative patients is associated with poor survival outcomes and may be caused by excessive fluid administration.

Currently, there is no solid evidence regarding the amount and type of fluid to be administered to these patients.

A survey was conducted to identify common fluid administration practices in children undergoing surgery for congenital or acquired heart disease. The analysis of 108 responses from 18 countries across the world indicated that isotonic solutions (42%), hypotonic solutions (33%), and crystalloid solutions (14%) are the most frequently IV maintenance fluids used.

Approximately half of the respondents limit the amount of fluid intake to 50% of the calculated total amount during the first 24 hours after surgery with cardiopulmonary bypass. For 44% of the respondents, 0.9% saline solution is the preferred choice for resuscitation, followed by colloids for 27%.

Economic, access, and scientific aspects that may influence decision making were also surveyed.

Although almost half of the respondents claimed that cost is not a determinant factor in choice of fluid, there was great variability regarding which is considered the ‘optimal’ fluid for maintenance and resuscitation, with the large majority agreeing that further studies in this field are much needed.