ArticleBMC pediatrics2020
Fluid therapy in mechanically ventilated critically ill children: the sodium, chloride and water burden of fluid creep.
Article in BMC pediatrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 29 citations in OpenAlex.
- REstrictive versus StandarD FlUid Management in Mechanically Ventilated ChildrEn Admitted to PICU: a pilot randomized controlled trial (REDUCE-1).Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2026Trial
- Impact of protocolized restrictive versus liberal/usual maintenance fluid strategy on fluid overload among mechanically ventilated children: an open-label randomized trial (ReLiSCh-II trial).European journal of pediatrics · 2026Trial
- Effect of normal saline and half saline preservation serums on sodium levels, blood pressure, and acidosis in PICU patients.Medicine · 2026Trial
- Dialytic sodium removal in children with acute kidney injury treated with peritoneal dialysis.Pediatric nephrology (Berlin, Germany) · 2026Trial
- Pattern of Fluid Overload and its Impact on Mortality Among Mechanically Ventilated Children: Secondary Analysis of the ReLiSCh Trial.Indian journal of pediatrics · 2025Trial
- Restricted versus Usual/Liberal Maintenance Fluid Strategy in Mechanically Ventilated Children: An Open-Label Randomized Trial (ReLiSCh Trial).Indian journal of pediatrics · 2025Trial
- Gravity-assisted continuous flow peritoneal dialysis technique use in acute kidney injury in children: a randomized, crossover clinical trial.Pediatric nephrology (Berlin, Germany) · 2023Trial
- Association between early fluid overload and clinical outcomes in a pediatric ICU.Pediatric research · 2026Observational
- Fluid Creep as an Independent Predictor of Fluid Overload and Mortality in Critically Ill Patients: A Cohort Study.Life (Basel, Switzerland) · 2025Article
- Determination of insensible water loss and sodium accumulation behavior from the Medtronic Nautilus Extracorporeal Membrane Oxygenation (ECMO) oxygenator: An in vitro study.The journal of extra-corporeal technology · 2025Article
- The determinants of fluid accumulation in critically ill children: a prospective single-center cohort study.Pediatric nephrology (Berlin, Germany) · 2025Article
- Incidence of and risk factors for acute kidney injury in neonates with congenital diaphragmatic hernia.European journal of pediatrics · 2025Article
- Fluid Overload in Children Following Hematopoietic Cell Transplant: A Comprehensive Review.Journal of clinical medicine · 2024Review
- The Correlation of Fluid Creep with Fluid and Electrolyte Imbalance In Pediatric Intensive Care Unit Dr. Cipto Mangunkusumo National Central Public Hospital.Turkish archives of pediatrics · 2024Article
- A burden of fluid, sodium, and chloride due to intravenous fluid therapy in patients with respiratory support: a post-hoc analysis of a multicenter cohort study.Annals of intensive care · 2022Article
- Management and outcomes of acute post-streptococcal glomerulonephritis in children.World journal of nephrology · 2022Review
- Current Practice of Fluid Maintenance and Replacement Therapy in Mechanically Ventilated Critically Ill Children: A European Survey.Frontiers in pediatrics · 2022Article
- Hypotonic or isotonic maintenance fluids for paediatric patients: the never-ending story.Anaesthesiology intensive therapy · 2020Article
- A Standardized Approach to Reduce Fluid Overload in Critically Ill Children.Pediatric quality & safetyArticle
- Children with malignancies and septic shock - an attempt to understand the risk factors.Jornal de pediatriaArticle
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFluid therapy is a cornerstone of pediatric intensive care medicine. We aimed at quantifying the load of water, sodium and chloride due to different fluid indications in our pediatric intensive care unit (PICU). We were particularly interested in the role of fluid creep, i.e. fluid administered mainly as the vehicle for drugs, and the association between sodium load and water balance.
methodsCritically ill children aged ≤3 years and invasively ventilated for ≥48 h between 2016 and 2019 in a single tertiary center PICU were retrospectively enrolled. Need for renal replacement therapy, plasmapheresis or parenteral nutrition constituted exclusion criteria. Quantity, quality and indication of fluids administered intravenously or enterally, urinary output and fluid balance were recorded for the first 48 h following intubation. Concentrations of sodium and chloride provided by the manufacturers were used to compute the electrolyte load.
resultsForty-three patients (median 7 months (IQR 3-15)) were enrolled. Patients received 1004 ± 284 ml of water daily (153 ± 36 ml/kg/day), mainly due to enteral (39%), creep (34%) and maintenance (24%) fluids. Patients received 14.4 ± 4.8 mEq/kg/day of sodium and 13.6 ± 4.7 mEq/kg/day of chloride, respectively. The majority of sodium and chloride derived from fluid creep (56 and 58%). Daily fluid balance was 417 ± 221 ml (64 ± 30 ml/kg/day) and was associated with total sodium intake (r
conclusionsCritically ill children are exposed, especially in the acute phase, to extremely high loads of water, sodium and chloride, possibly contributing to edema development. Fluid creep is quantitatively the most relevant fluid in the PICU and future research efforts should address this topic in order to reduce the inadvertent water and electrolyte burden and improve the quality of care of critically ill children.
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