Yuniar Irene, Sihotang Jojor, Suriadi Regina, June Devina
Division of Pediatric Emergency and Critical Care, Department of Child Health, Dr. Cipto Mangunkusumo National Central Public Hospital, Central Jakarta, Indonesia.
Division of Pediatric Intensive Care Unit Dr. Cipto Mangunkusumo National Central Public Hospital, Central Jakarta, Indonesia.
Turk Arch Pediatr. 2024 Jul 1;59(4):353-357. doi: 10.5152/TurkArchPediatr.2024.23309.
Fluid creep, used as a drug diluent can contribute to fluid and electrolyte balance. Fluid creep brings substantial volume and electrolyte load to patients, especially in critically ill children. This study is conducted to evaluate the correlation of fluid creep with fluid and electrolyte balance in critically ill children. This cross-sectional study was conducted in a single tertiary center. We include children aged 1 month- 18 years in the pediatric intensive care unit (PICU). Exclusion criteria were patients receiving renal replacement therapy and plasmapheresis. Fluids and electrolyte intake were recorded at admission and the first 24 hours in the PICU. A total of 64 patients were observed. The sources of fluid intake are 61% from parenteral, 25% from enteral nutrition, and 12% from fluid creep. There were significant correlations between the volume (r = 0.304, P = .015) and electrolyte intake (r = 0.742, P = .035) of fluid creep with daily fluid balance. There is no correlation between fluid creep and electrolyte changes in 24 hours. Fifty-two patients used WFI (81.2%) as a drug diluent. Our study showed that fluid creep constitutes 12% of daily fluid intake. There is a correlation between the volume and electrolyte intake from fluid creep to daily fluid balance, so it is important to include the volume of fluid creep in calculating the fluid balance. Thus, it is recommended to use hypotonic fluid like WFI compared to NaCl 0.9% for drug diluent.
用作药物稀释剂的液体蠕动有助于维持体液和电解质平衡。液体蠕动给患者带来大量的液体和电解质负荷，尤其是危重症儿童。本研究旨在评估危重症儿童中液体蠕动与体液和电解质平衡的相关性。这项横断面研究在一家三级中心进行。我们纳入了儿科重症监护病房（PICU）中年龄在1个月至18岁的儿童。排除标准为接受肾脏替代治疗和血浆置换的患者。记录患者入院时及在PICU的头24小时内的液体和电解质摄入量。共观察了64例患者。液体摄入来源为61%来自肠外途径，25%来自肠内营养，12%来自液体蠕动。液体蠕动的量（r = 0.304，P = .015）和电解质摄入量（r = 0.742，P = .035）与每日液体平衡之间存在显著相关性。液体蠕动与24小时内的电解质变化无相关性。52例患者使用注射用水（WFI）（81.2%）作为药物稀释剂。我们的研究表明，液体蠕动占每日液体摄入量的12%。液体蠕动的量和电解质摄入量与每日液体平衡之间存在相关性，因此在计算液体平衡时纳入液体蠕动的量很重要。因此，建议与0.9%氯化钠相比，使用注射用水等低渗液体作为药物稀释剂。
