Anesthesia/Sedation Preoperative Care and Preparation Clinical Pathway, Inpatient and Emergency Department – IV Fluid Recommendations

Anesthesia/Sedation Preoperative Care and Preparation Clinical Pathway, Inpatient and Emergency Department

IV Fluid Recommendations

  • Allow child clear liquids per Enteral Intake Timing Before Procedures guidance.
  • Most children do not require continuous IV fluids (IVF). Hydration can be managed with intermittent IVF boluses.
  • Exceptions, including those at risk for hypoglycemia or dehydration are listed in table below.
  • If maintenance fluids deemed medically necessary, continue IV fluids through transport to PACU or procedure area.
Population Considerations
At Risk for Hypoglycemia
e.g., < 1 yr of age, diabetes mellitus, dextrose-containing fluids > D10, history of hypoglycemia
 Assess need for dextrose-containing maintenance IV fluids to decrease risk for hypoglycemia if unable to take oral fluids < 2 hrs prior to procedure
Delayed Gastric Emptying
Intestinal Obstruction
e.g., malrotation, pyloric stenosis, esophageal disease
Achalasia
  • Ensure euvolemia
  • Risk for hypoglycemia and dehydration due to primary disease
Sickle Cell Anemia
  • Fluids may be given orally if tolerated
  • Consider IV fluids to reduce risk of sickle cell complications
    • e.g., VOC, ACS, stroke
Moyamoya
ICU Patients Maintain continuous IV fluids
Diabetes Insipidus May be fluid restricted – discuss with Endocrinology