Lee Jiwon M, Jung Younghwa, Lee Se Eun, Lee Jun Ho, Kim Kee Hyuck, Koo Ja Wook, Park Young Seo, Cheong Hae Il, Ha Il-Soo, Choi Yong, Kang Hee Gyung
Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
Korean J Pediatr. 2013 Jul;56(7):282-5. doi: 10.3345/kjp.2013.56.7.282. Epub 2013 Jul 19.
Recent studies have established the association between hypotonic fluids administration and hospital-acquired hyponatremia in children. The present paper investigated the pattern of current practice in intravenous fluid prescription among Korean pediatric residents, to underscore the need for updated education.
A survey-based analysis was carried out. Pediatric residents at six university hospitals in Korea completed a survey consisting of four questions. Each question proposed a unique scenario in which the respondents had to prescribe either a hypotonic or an isotonic fluid for the patient.
Ninety-one responses were collected and analyzed. In three of the four scenarios, a significant majority prescribed the hypotonic fluids (98.9%, 85.7%, and 69.2%, respectively). Notably, 69.2% of the respondents selected the hypotonic fluids for postoperative management. Almost all (96.7%) selected the isotonic fluids for hydration therapy.
In the given scenarios, the majority of Korean pediatric residents would prescribe a hypotonic fluid, except for initial hydration. The current state of pediatric fluid management, notably, heightens the risk of hospital-acquired hyponatremia. Updated clinical practice education on intravenous fluid prescription, therefore, is urgently required.
近期研究已证实儿童输注低渗液与医院获得性低钠血症之间存在关联。本文调查了韩国儿科住院医师静脉输液处方的当前实践模式，以强调更新教育的必要性。
进行了一项基于调查的分析。韩国六所大学医院的儿科住院医师完成了一项包含四个问题的调查。每个问题提出了一个独特的场景，要求受访者为患者开具低渗液或等渗液。
收集并分析了91份回复。在四个场景中的三个场景中，绝大多数人开具了低渗液（分别为98.9%、85.7%和69.2%）。值得注意的是，69.2%的受访者选择低渗液用于术后管理。几乎所有受访者（96.7%）选择等渗液用于补液治疗。
在给定场景中，除初始补液外，大多数韩国儿科住院医师会开具低渗液。值得注意的是，目前儿科液体管理的现状增加了医院获得性低钠血症的风险。因此，迫切需要更新关于静脉输液处方的临床实践教育。
