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Korean J Pediatr 2013 July;56(7) :282-285.
Published online 2013 July 04.        doi:
Intravenous fluid prescription practices among pediatric residents in Korea
Jiwon M. Lee1, Younghwa Jung1, Se Eun Lee1, Jun Ho Lee2, Kee Hyuck Kim3, Ja Wook Koo4, Young Seo Park5, Hae Il Cheong1,6,7, Il-Soo Ha1,7, Yong Choi1, Hee Gyung Kang1,6
1Department of Pediatrics, Seoul National University Childrens Hospital, Seoul, Korea
2Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
3Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
4Department of Pediatrics, Inje Unversity Sanggye Paik Hospital, Inje Unversity College of Medicine, Seoul, Korea
5Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
6Research Center for Rare Diseases, Seoul National University Hospital, Seoul, Korea
7Kidney Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
Corresponding Author: Hee Gyung Kang ,Tel: +82-2-2072-0658, Fax: +82-2-2072-0274, Email:
Copyright © 2013 by The Korean Pediatric Society
Purpose: Recent studies have established the association between hypotonic fluids administration and hospital-acquired hyponatremia in children, and have contended that hypotonic fluids be removed from routine practice. To assess current intravenous fluid prescription practices among Korean pediatric residents and to call for updated clinical-practice education
Methods: A survey-based analysis was carried out. Pediatric residents at six university hospitals in Korea completed a survey consisting of four questions. Each question supposed a unique scenario in which the respondents were to prescribe either a hypotonic or an isotonic fluid for the patient.
Results: Ninety-one responses were collected and analyzed. In three of the four scenarios, a significant majority prescribed the hypotonic fluids (98.9%, 85.7%, and 69.2%, respectively). Notably, 69.2% of the respondents selected the hypotonic fluids for postoperative management. Almost all (96.7%) selected the isotonic fluids for hydration therapy.
Conclusion: In the given scenarios, the majority of Korean pediatric residents would prescribe a hypotonic fluid, except for initial hydration. The current state of pediatric fluid management, notably, heightens the risk of hospital-acquired hyponatremia. Updated clinical practice education on intravenous fluid prescription, therefore, is urgently required.
Keywords: Pediatrics | Intravenous | Infusions | Fluid therapy | Hyponatremia | Maintenance
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