This page is part of the 10N-Matrix for a high quality conduct of pediatric anesthesia.
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Definition
Maintenance of expected circulating blood volume and body fluid homeostasis of the patient (age dependent).
Importance
Maintenance of physiological body fluid homeostasis is important for normal organ function. Deviations from this equilibrium (hypo- and hypervolemia) are commonly encountered in the peri-operative period.
Consequences
Hypovolemia
- results in hypoperfusion and tissue hypoxia
- hypovolemia is the leading cause of perioperative cardiac arrests (POCA) in children.
Hypervolemia
- dilutional coagulopathy
- tissue edema
Prevention and treatment
- preoperative clinical assessment (capillary refill time, urinary output) and correct preoperative disturbances if required
- consider using other monitors which may include: Invasive pressure monitoring, SvO2, periodical arterial blood gas analysis (acid base state) and non-invasive cardiac output monitors
Hypovolemia
- avoid prolonged fasting times which can lead to hypovolemia
- correct / minimize pre-operative deficits
- sufficient IV access
- maintenance fluids
- blood and coagulation management
Hypervolemia
- close monitoring and control of fluid administration
- correction of intraoperative coagulopathy
Further reading
- coming soon…
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Review all 10N
- No Fear / No Awareness
- Normovolemia
- Normotension
- Normal Heart Rate
- Normoxemia
- Normocapnia
- Normonatremia
- Normoglycemia
- Normothermia
- No Postoperative Discomfort:
- No Pain
- No PONV
- No Emergence Delirium