logo
episode-header-image
Apr 2021
36m 56s

103 Pediatric IV Fluids

STEVE CARROLL, DO
About this episode

Pediatric intensivist Dr. Will Cagle joins the show to discuss the AAP Maintenance IV fluid guidelines and considerations when choosing IV fluids for pediatric inpatients.

What do you need to know from the 2018 AAP maintenance IV fluid guideline? 

How common is hyponatremia in hospitalized patients and why does it matter to your practice? 

What is SIADH and how does it contribute to hyponatremia in acutely ill children? 

How can we prevent hyponatremia in our hospitalized patients? 

What are the differences between hypotonic and isotonic fluids? 

What are balanced solutions and why might they be preferred as compared to saline in some clinical settings? 

All of this and more from the Department of Pediatrics and the Medical College of Georgia. 

Check out our website for detailed show-notes: https://www.augusta.edu/mcg/pediatrics/residency/podcast.php

Special thanks to Dr. Asif Mansuri and Dr. Gene Fisher for providing peer review for this episode.

Questions, comments, or feedback? Please email us at mcgpediatricpodcast@augusta.edu 

Want Further Reading? Check out the clinical practice guideline from the AAP and our other references below.

  • Feld LG,Neuspiel DR, Foster BA, et al. Clinical Practice Guideline: Maintenance Intravenous Fluids in Children. Pediatrics. 2018;142(6):e20183083. doi:10.1542/peds.2018-3083 
  • Semler MW, Self WH, Wanderer JP, et al. Balanced Crystalloids versus Saline in CriticallyIll Adults. N Engl J Med. 2018;378(9):829-839. doi:10.1056/NEJMoa1711584 
  • CuzzoB, Padala SA, Lappin SL. Vasopressin (Antidiuretic Hormone, ADH) [Updated 2020 Apr 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526069/ 
  • Chowdhury, Abeed H. BSc, MRCS*; Cox, Eleanor F. PhD†; Francis, Susan T. PhD†; Lobo, Dileep N. DM, FRCS, FACS*A Randomized, Controlled, Double-Blind Crossover Study on the Effects of 2-L Infusions of 0.9% Saline and Plasma-Lyte® 148 on Renal Blood Flow Velocity and Renal Cortical Tissue Perfusion in Healthy Volunteers, Annals of Surgery: July 2012 - Volume 256 - Issue 1 - p 18-24 doi: 10.1097/SLA.0b013e318256be72 
  • Peti-Peterdi J, Harris RC. Maculadensa sensing and signaling mechanisms of renin release. J Am Soc Nephrol. 2010;21(7):1093-1096. doi:10.1681/ASN.2009070759 
  • Wilcox CS. Regulation of renal blood flow by plasma chloride.J Clin Invest. 1983;71(3):726-735. doi:10.1172/jci110820 
Up next
Feb 2025
111 Hyperkalemia
Dr. Jordan Cramer joins Dan McCollum to discuss the management of hyperkalemia. Learn key aspects of the history and physical Discuss the importance of an early ECG. Discover important details about a variety of treatment options. 
24m 13s
Apr 2023
110 GI bleeds or Gastrointestinal Hemorrhage
Join Dr. Mike Wallace and Dan McCollum as they discuss the management of patients with gastrointestinal hemorrhage. What is the initial management of these patients? Who requires blood transfusions? Which patients require admission to the floor or the ICU? Pearls and pitfalls in ... Show More
28m 22s
Mar 2023
109 Ear and Nasal Foreign Bodies
Join Dr. Alex Koo as he discusses ear and nasal foreign bodies. He'll give you a brief run-down of anatomy, history, and physical, before diving into comprehensive, key concepts of foreign body removal. There will be some great tips and tricks shared! -Where do foreign bodies com ... Show More
18m 44s
Recommended Episodes
Nov 2022
Podcast 833: NS vs LR
<p><strong>Contributor: Travis Barlock, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Normal Saline (NS) contains 154 mEq of both Sodium (Na) and Chloride (Cl),  and has a pH of 5.5</ ... Show More
5m 16s
Aug 2022
Podcast 802: Intranasal Medication Administration for Pediatric Patients
<p><strong>Contributor: Aaron Lessen, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Intranasal medication administration is a convenient, quick, and relatively painless option for ped ... Show More
3m 24s
May 2017
Episode 95 Pediatric Trauma
Management of the pediatric trauma patient is challenging regardless of where you work. In this EM Cases episode, with the help of two leading pediatric trauma experts, Dr. Sue Beno from Hospital for Sick Children in Toronto and Dr. Faud Alnaji from Children's Hospital of Eastern ... Show More
1h 40m
Feb 2021
21: Should smaller endotracheal tubes be used for elective surgery?
<p class="p1"><span class="s1">In this episode, we explore the evidence on whether smaller endotracheal tubes are...</span></p> <p class="p1"><span class="s1">1. Less likely to maintain a secure patent airway</span></p> <p class="p1"><span class="s1">2. Less reliable in facilitat ... Show More
38m 33s
Sep 2022
Episode 53: Insights into Modern Critical Care with Dr. Jean-Louis Vincent: Part II
In this episode, we talk all things critical care the one and only, Dr. Jean-Louis Vincent aka. JLV. This episode is a MUST listen. We touch upon the evolution of early goal directed therapy, measures of fluid responsiveness, optimizing oxygen delivery, and the importance of inte ... Show More
34m 18s
Mar 2022
REBOOT #145 Hepatorenal Syndrome
Tackle the complex pathophysiology, diagnosis, and management of hepatorenal syndrome in this Curbsiders classic from #NephMadness 2019 featuring @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier ( ... Show More
1h 8m
Jan 2020
11: Does cricoid pressure reduce the risk of pulmonary aspiration?
<p><!-- wp:paragraph --></p> <p>For our first episode of 2020, we investigate claims related to the application of cricoid pressure.</p> <p>Claim 1. Cricoid pressure reduces the risk of pulmonary aspiration.</p> <p>Claim 2. Landmark technique is able to accurately identify the cr ... Show More
35m 33s
Oct 2019
9: Is it safe to peripherally administer norepinephrine?
<p class="p1">We investigate the claim that norepinephrine is not safe for peripheral administration.</p> <p class="p1">Our guests today are Dr. Katarina Ruscic and Dr. Jamie Sparling of the Critical Care Division of the Massachusetts General Hospital. </p> <p class="p1">Full sho ... Show More
45m 39s
Nov 2020
19: Is hydrocortisone, ascorbic acid (Vitamin C), and thiamine therapy effective for treatment of sepsis?
<p class="p1"><span class="s1">In this episode, we discuss the role of hydrocortisone, ascorbic acid (Vitamin C) and thiamine (HAT therapy) in the treatment of patients with septic shock. We discuss biological plausibility and comprehensively review the latest evidence.</span></p ... Show More
25m 18s
May 2024
May 10 2024 This Week in Cardiology
<p>Inclisiran, sodium-channel blocker safety, analytic flexibility, the work-up of patients with HF, and BP in older patients are the topics John Mandrola, MD, covers in this week's podcast.</p> <p><em>This podcast is intended for healthcare professionals only</em>.</p> <p>To rea ... Show More
31m 56s