TY - JOUR T1 - Intravenous fluid therapy in children and young people in hospital N29 JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed DO - 10.1136/archdischild-2016-310648 SP - edpract-2016-310648 AU - Jessica Green AU - Jonathan Lillie Y1 - 2017/08/04 UR - http://ep.bmj.com/content/early/2017/08/06/archdischild-2016-310648.abstract N2 - The prescription of intravenous fluids requires an understanding of fluid homeostasis and should be tailored to the individual, the disease and the intended therapeutic goal. Errors in prescribing or administration can increase morbidity, with inadequate provision causing hypovolaemia and poor organ perfusion, and excessive fluids leading to overload and cardiac failure. Failing to correct electrolyte imbalances can result in neurological sequelae and even death.In December 2015, the National Institute for Care Excellence (NICE) addressed the lack of guidance by publishing ‘Intravenous fluid therapy in children and young people in hospital NG29’1. Endorsed by the Royal College of Paediatrics and Child Health, its aim was to offer a ‘standardised approach to assessing patient's fluid and electrolyte status and prescribing IV fluid therapy in term neonates, children and young people’.Previous guidelinesAlthough there is no previous national consensus for intravenous fluid prescription in children, some guidance in certain paediatric scenarios is embedded in other NICE guidelines (see  box 1).Box 1 ResourcesIntravenous fluid therapy in children and young people in hospital NICE guideline, December 2015 N29, https://www.nice.org.uk/guidance/ng29/resources/intravenous-fluid-therapy-in-children-and-young-people-in-hospital-1837340295109Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management NICE guideline CG84, April 2009, https://www.nice.org.uk/guidance/cg84Diabetes (type 1 and type 2) in children and young people: diagnosis and management NICE clinical guideline NG18, August 2015, https://www.nice.org.uk/guidance/ng18Fever in under 5s: assessment and in children NICE clinical guideline CG160, https://www.nice.org.uk/guidance/cg160NICE, National Institute for Care Excellence.Key issues that the guideline addressesprovides a standardised approach for the initial prescription of intravenous fluid in children for maintenance, fluid resuscitation and replacement/redistributionoffers standards for monitoring children who are receiving intravenous fluidspresents algorithms for the management of hypernatraemia and hyponatraemia that may develop during fluid administration.Box 2 Factors to consider prior to prescription of intravenous fluidsAgeWeightPrematurityRisk of increased antidiuretic hormone secretion (see box 4)BurnsDiabetic ketoacidosisFeverMechanical ventilation (decreases insensible … ER -