New highlights added June 15, 2024 at 4:03 PM

• Traditionally, 5% glucose is added to paediatric maintenance infusions. In the perioperative context, this can lead to hyperglycaemia [14]. Surgical stress increases plasma counter-insulin hormone levels (e.g. cortisol, glucagon, epinephrine, and growth hormone) and decreases plasma insulin levels, which leads to a hyperglycaemia-induced catabolic state (View Highlight)
• children in a catabolic state or with low glycogen reserves such as infants, children with liver disease, malnourishment or burns and children with prolonged fasting times are in danger of hypoglycaemia (View Highlight)

New highlights added June 15, 2024 at 5:01 PM

• after 1–2 h and especially in children with relevant fluid deficits or overload, the maintenance infusion rate should be adjusted to the actual requirements (View Highlight)
• The potential base excess (BEpot) of a fluid describes the sum of hydrogen ions infused with the mostly acidic electrolyte solutions and the hydrogen ions consumed by the complete metabolisation of the organic anions in the electrolyte solution (View Highlight)
• As no standard values or lower limit values for NIRS in children have yet been established in studies, a strategy involving measurement of a baseline value in an awake child in room air can be recommended (View Highlight)
• The NIRS value is influenced by heart rate, blood pressure, arterial oxygen saturation, carbon dioxide partial pressure, and haemoglobin concentration [35]. These would be the target parameters that need to be optimised if the NIRS falls below the baseline value. (View Highlight)
• While the extracellular space is larger in small children relative to their body weight, the proportion of blood volume in the extracellular fluid is lower than in older children and adults (new-borns 10%, infants 20%, adults 25%). As a consequence, crystalloid solutions cause an even smaller effect on intravascular volume of infants and toddlers (View Highlight)
• While the extracellular space is larger in small children relative to their body weight, the proportion of blood volume in the extracellular fluid is lower than in older children and adults (new-borns 10%, infants 20%, adults 25%). As a consequence, crystalloid solutions cause an even smaller effect on intravascular volume of infants and toddlers (View Highlight)
• Gelatine is said to have a high allergenic potential. However, a prospective observational study from 13 European centres with 601 children reported no allergic reactions (View Highlight)
• Albumin is extracted from human blood but considered as virus safe. It is the most expensive colloid besides plasma (View Highlight)