Intravenous Fluids — Getting the Balance Right

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Abstract
Acute infections are a major cause of illness and death in children worldwide. In Africa, 50 percent of in-hospital deaths of children occur within 24 hours of admission, and shock complicates many cases.1 The provision of emergency advanced life support for critically ill children would have an important effect on survival in the developing world, where acute infections are common.1,2 Ways must be found of ensuring emergency care in resource-poor settings, where sophisticated point-of-care analyses, intensive monitoring, and specialist care are rarely present; basic laboratory studies cannot be done in a timely fashion; the choice of intravenous fluids is limited; infusion pumps and equipment sized for children are scarce; and often the primary diagnosis is unconfirmed and complicated by delay, poor nutritional status, and possibly HIV infection.