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- Title
Fluid resuscitation in neonatal and pediatric hypovolemic shock: a Dutch Pediatric Society evidence-based clinical practice guideline.
- Authors
Boluyt, Nicole; Bollen, Casper; Bos, Albert; Kok, Joke; Offringa, Martin; Bollen, Casper W; Bos, Albert P; Kok, Joke H
- Abstract
<bold>Objective: </bold>To develop a clinical practice guideline that provides recommendations for the fluid, i.e. colloid or crystalloid, used for resuscitation in critically ill neonates and children up to the age of 18 years with hypovolemia.<bold>Methods: </bold>The guideline was developed through a comprehensive search and analysis of the pediatric literature. Recommendations were formulated by a national multidisciplinary committee involving all stakeholders in neonatal and pediatric intensive care and were based on research evidence from the literature and, in areas where the evidence was insufficient or lacking, on consensus after discussions in the committee.<bold>Results: </bold>Because of the lack of evidence in neonates and children, trials conducted in adults were considered. We found several recent meta-analyses that show excess mortality in albumin-treated groups, compared with crystalloid-treated groups, and one recent large randomized controlled trial that found evidence of no mortality difference. We found no evidence that synthetic colloids are superior to crystalloid solutions.<bold>Conclusions: </bold>Given the state of the evidence and taking all other considerations into account, the guideline-developing group and the multidisciplinary committee recommend that in neonates and children with hypovolemia the first-choice fluid for resuscitation should be isotonic saline.
- Subjects
NETHERLANDS; RESUSCITATION; SHOCK (Pathology); PEDIATRICS; CRITICAL care medicine; CRITICALLY ill; PHYSIOLOGIC salines; BLOOD volume; COMPARATIVE studies; FLUID therapy; RESEARCH methodology; MEDICAL cooperation; RESEARCH; EVIDENCE-based medicine; EVALUATION research; THERAPEUTICS
- Publication
Intensive Care Medicine, 2006, Vol 32, Issue 7, p995
- ISSN
0342-4642
- Publication type
journal article
- DOI
10.1007/s00134-006-0188-4