Perioperative fluid therapy in pediatric patients

Abstract

Fluid therapy in pediatric patients plays a fundamental role in perioperative anesthetic management. Planning of all surgical procedures must take into account the fluid therapy necessary to maintain both the basal metabolic needs and the losses derived from surgery. Generally, maintenance fluid therapy is performed with balanced hydro electrolytic solutions plus glucose (although the latter may not be necessary in most pediatric surgeries), and replacement fluid therapy with glucose-free solutions, with crystalloids being the most frequently used. Surgeries that present significant losses require a replacement fluid plan that allows maintaining an adequate intravascular volume, allowing an appropriate return and ventricular filling, as well as adequate tissue transport of oxygen. When necessary, transfusion of blood products should be aimed at reestablishing the necessary conditions to maintain homeostasis during the perioperative period.