Davies Polly, Hall Tim, Ali Tariq, Lakhoo Kokila
Department of Paediatric Surgery, John Radcliffe Hospital, Oxford, UK.
BMC Surg. 2008 Jun 9;8:10. doi: 10.1186/1471-2482-8-10.
Postoperative deaths and neurological injury have resulted from hyponatraemia associated with the use of hypotonic saline solutions following surgery. We aimed to determine the rates and types of intravenous fluids being prescribed postoperatively for children in the UK.
A questionnaire was sent to members of the British Association of Paediatric Surgeons (BAPS) and Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) based at UK paediatric centres. Respondents were asked to prescribe postoperative fluids for scenarios involving children of different ages. The study period was between May 2006 and November 2006.
The most frequently used solution was sodium chloride 0.45% with glucose 5% although one quarter of respondents still used sodium chloride 0.18% with glucose 4%. Isotonic fluids were used by 41% of anaesthetists and 9.8% of surgeons for the older child, but fewer for infants. Standard maintenance rates or greater were prescribed by over 80% of respondents.
Most doctors said they would prescribe hypotonic fluids at volumes equal to or greater than traditional maintenance rates at the time of the survey. A survey to describe practice since publication of National Patient Safety Agency (NPSA) recommendations is required.
术后死亡和神经损伤与手术后使用低渗盐溶液导致的低钠血症有关。我们旨在确定英国儿童术后静脉输液的使用比例和类型。
向英国儿科中心的英国小儿外科医生协会（BAPS）和大不列颠及爱尔兰小儿麻醉师协会（APAGBI）成员发送问卷。要求受访者针对不同年龄儿童的情况开具术后输液处方。研究时间段为2006年5月至2006年11月。
最常使用的溶液是0.45%氯化钠加5%葡萄糖，不过四分之一的受访者仍使用0.18%氯化钠加4%葡萄糖。41%的麻醉师和9.8%的外科医生为年龄较大儿童使用等渗液，但为婴儿使用的较少。超过80%的受访者开具标准维持量或更大剂量。
大多数医生表示，在调查时他们会开具等于或大于传统维持量的低渗液。需要进行一项调查，以描述自国家患者安全机构（NPSA）发布建议以来的实际做法。
