Korean J Pediatr.  2013 Jul;56(7):282-285. 10.3345/kjp.2013.56.7.282.

Intravenous fluid prescription practices among pediatric residents in Korea

Affiliations
  • 1Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea. kanghg@snu.ac.kr
  • 2Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
  • 3Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
  • 4Department of Pediatrics, Inje Unversity Sanggye Paik Hospital, Inje Unversity College of Medicine, Seoul, Korea.
  • 5Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 6Research Center for Rare Diseases, Seoul National University Hospital, Seoul, Korea.
  • 7Kidney Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Recent studies have established the association between hypotonic fluids administration and hospital-acquired hyponatremia in children, and have contended that hypotonic fluids be removed from routine practice. To assess current intravenous fluid prescription practices among Korean pediatric residents and to call for updated clinical practice education.
METHODS
A survey-based analysis was carried out. Pediatric residents at six university hospitals in Korea completed a survey consisting of four questions. Each question supposed a unique scenario in which the respondents were to prescribe either a hypotonic or an isotonic fluid for the patient.
RESULTS
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.
CONCLUSION
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.

Keyword

Pediatrics; Intravenous; Infusions; Fluid therapy; Hyponatremia; Maintenance

MeSH Terms

Child
Surveys and Questionnaires
Fluid Therapy
Hospitals, University
Humans
Hyponatremia
Korea
Pediatrics
Prescriptions
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