CHU de Caen, Pediatric Intensive Care Unit, 14000, Caen, France.
Medical School, Université Caen Normandie, 14000, Caen, France.
Eur J Pediatr. 2024 Jun;183(6):2797-2803. doi: 10.1007/s00431-024-05514-6. Epub 2024 Mar 18.
Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care. Recently paediatric societies have produced evidence-based practice guidelines that recommend the use of balanced isotonic fluid when prescribing IV-MFT in both acute and critical paediatric care. Unfortunately, the applicability of these guidelines could be called into question when a ready-to-use glucose-containing balanced isotonic fluid is not available. The main objective of this study was to describe the availability of glucose-containing balanced isotonic fluids in European and Middle Eastern paediatric acute and critical care settings. This work is an ancillary study of the survey dedicated to IV-MFT practices in the paediatric acute and critical care settings in Europe and Middle East, a cross-sectional electronic 27-item survey, emailed in April-May 2021 to paediatric critical care physicians across 34 European and Middle East countries. The survey was developed by an expert multi-professional panel within the European Society of Peadiatric and Neonatal Intensive Care (ESPNIC). Balanced isotonic fluid with glucose 5% was available for only 32/153 (21%) responders. Balanced isotonic fluid with glucose 5% was consistently available in the UK (90%) but not available in France, Greece, The Netherlands and Turkey. Conclusion: Ready-to-use isotonic balanced IV solutions containing glucose in sufficient amount exist but are inconsistently available throughout Europe. National and European Medication Safety Incentives should guarantee the availability of the most appropriate and safest IV-MFT solution for all children. What is Known: • Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care. • Balanced isotonic fluid is recommended when prescribing IV-MFT in both acute and critical paediatric care. What is New: • Balanced isotonic fluid with glucose 5% is available for less than 25% of the prescribers in Europe and the Middle East. Availability of balanced isotonic fluid with glucose 5% varies from one country to another but can also be inconsistent within the same country. • Clinicians who have access to a ready-to-use balanced isotonic fluid with glucose 5% are more likely to consider its use than clinicians who do not have access to such an IV solution.
静脉补液维持治疗（IV-MFT）可能是儿科医院治疗中最常开具的药物。最近，儿科协会已经制定了基于证据的实践指南，建议在急性和危重症儿科护理中开具 IV-MFT 时使用平衡等渗液。不幸的是，当无法获得即用型含葡萄糖的平衡等渗液时，这些指南的适用性可能会受到质疑。本研究的主要目的是描述欧洲和中东儿科急性和危重症环境中含葡萄糖的平衡等渗液的供应情况。这项工作是一项辅助研究，调查对象是欧洲和中东儿科急性和危重症环境中 IV-MFT 实践情况，采用横断面电子 27 项调查，于 2021 年 4 月至 5 月间通过电子邮件发送给 34 个欧洲和中东国家的儿科重症监护医师。该调查由欧洲儿科和新生儿重症监护学会（ESPNIC）内的一个多专业专家小组开发。在 153 名应答者中，只有 32 名（21%）可以获得 5%葡萄糖的平衡等渗液。英国（90%）始终可以获得 5%葡萄糖的平衡等渗液，但法国、希腊、荷兰和土耳其没有。结论：存在即用型含足够葡萄糖的等渗平衡 IV 溶液，但在整个欧洲的供应情况并不一致。国家和欧洲药物安全激励措施应确保为所有儿童提供最合适和最安全的 IV-MFT 溶液。已知：•静脉补液维持治疗（IV-MFT）可能是儿科医院治疗中最常开具的药物。•在急性和危重症儿科护理中开具 IV-MFT 时，建议使用平衡等渗液。新内容：•在欧洲和中东，不到 25%的处方医生可以获得 5%葡萄糖的平衡等渗液。•各国之间 5%葡萄糖的平衡等渗液供应情况各不相同，在同一国家内也可能不一致。•有条件获得即用型含 5%葡萄糖的平衡等渗液的临床医生比没有此类 IV 溶液的临床医生更有可能考虑使用该溶液。
