Benefits and risks Sublingual administration of sugar in treatment of hypoglycaemia
12. Evidence for recommendations on the choice of intravenous fluids
12.1 Choice of intravenous fluids for resuscitation and maintenance in
children a Resuscitation: Children severely dehydrated or with signs of shock should be resuscitated using isotonic intravenous IV solutions such as sodium chloride 0.9 or ringers lactate. Strong recommendation, low quality evidence b Intravenous maintenance luid: For children who require intravenous IV luids for maintenance, options include ringers lactate solution with 5 dextrose, sodium chloride 0.45 with glucose 5, sodium chloride 0.45 with glucose 2.5, or 0.9 sodium chloride with glucose 5. Strong recommendation, low quality evidence c Low sodium-containing IV solutions such as sodium chloride 0.18 with glucose 4, or 5 glucose in water, should not be used as there is an increased risk of hyponatraemia. Strong recommendation, low quality evidence here is evidence that there is a greater level of risk of hyponatraemia associated with the use of very low sodium-containing solutions in paediatric patients in comparison to luids where the sodium content is 75–150mmolL. he panel also emphasized that IV maintenance luids should contain glucose to avoid hypoglycaemia and starvation ketosis. Enteral feeding should be used in sick children, as it provides nutrition and avoids complications associated with IV luids. If oral nutrition is not tolerated, nasogastric tube feeding should be considered.12.1.1 Evidence and summary of findings
here is evidence of a greater level of risk of hyponatraemia associated with the use of hypotonic solutions: the odds of developing hyponatraemia following hypotonic solutions are 17.2 times greater than with isotonic luids. Within the range of hypo- tonic solutions available, the use of sodium chloride 0.18 with glucose 4 presents an even greater risk. he panel identiied a systematic review published in 2006 that sought to compare outcomes for children receiving hypotonic versus isotonic luid therapy [Choong, 2006]. he review included six studies: two controlled trials of children 1-12 years,Parts
» Hospital Care WHO evidence 0
» Objectives of the recommendations
» Management of conflict of interest
» Defining the scope Methodology and process
» Evidence retrieval and synthesis process
» Consensus building and external peer review
» Review and update of the recommendations
» Proposed subsidiary products Implementation of the recommendations
» Implementation of the recommendations
» National adaptation and implementation
» Management of neonatal jaundice Empirical antibiotics for suspected neonatal sepsis
» Antibiotic treatment for non-severe pneumonia with no wheeze
» Inhaled salbutamol for treatment of acute wheezeasthma and
» Antibiotics for treatment of acute otitis media
» Clinical signs for detection of hypoxaemia in children
» Oxygen delivery methods Criteria for starting and stopping oxygen therapy
» Evidence and summary of findings
» Benefits and risks Acceptability and feasibility
» Evidence and summary of findings Benefits and risks
» Acceptability and feasibility Management of neonatal jaundice
» Benefits and risks Head or whole body cooling in management of hypoxic ischaemic
» Acceptability and feasibility Head or whole body cooling in management of hypoxic ischaemic
» Evidence and summary of recommendations
» Acceptability and feasibility Kangaroo Mother Care
» Benefits and risks Prevention of hypothermia immediately after birth in low birth
» Acceptability and feasibility Prevention of hypothermia immediately after birth in low birth
» Benefits and risks Antibiotic treatment for non-severe pneumonia with wheeze
» Acceptability and feasibility Antibiotic treatment for non-severe pneumonia with wheeze
» Benefits and risks Antibiotic treatment for non-severe pneumonia with no wheeze
» Acceptability and feasibility Antibiotic treatment for non-severe pneumonia with no wheeze
» Benefits and risks Antibiotics treatment for severe pneumonia
» Acceptability and feasibility Antibiotics treatment for severe pneumonia
» Evidence and summary of findings Benefits and risks Acceptability and feasibility
» Acceptability and feasibility Salbutamol for treatment of acute wheezeasthma and
» Acceptability and feasibility Antibiotics for treatment of acute bacterial meningitis
» Benefits and risks Antibiotic treatment for Acute Otitis Media AOM
» Acceptability and feasibility Antibiotic treatment for Chronic Suppurative Otitis Media CSOM
» Benefits and risks Topical steroids for treatment of Chronic Suppurative Otitis Media
» Acceptability and feasibility Topical steroids for treatment of Chronic Suppurative Otitis Media
» Benefits and risks Antibiotic treatment for Typhoid Fever
» Acceptability and feasibility: Antibiotic treatment for Typhoid Fever
» Benefits and risks Antibiotics use in the management of severe acute malnutrition
» Acceptability and feasibility Antibiotics use in the management of severe acute malnutrition
» Acceptability and feasibility: Oxygen therapy in treatment of hypoxaemia
» Acceptability and feasibility Oxygen therapy delivery methods
» Benefits and risks Criteria for starting and stopping oxygen therapy
» Acceptability and feasibility Criteria for starting and stopping oxygen therapy
» Benefits and risks Sublingual administration of sugar in treatment of hypoglycaemia
» Acceptability and feasibility Sublingual administration of sugar in treatment of hypoglycaemia
» Benefits and risks Choice of intravenous fluids for resuscitation and maintenance in
» Vitamin K prophylaxis in newborns
» Skin-to-skin contact in the first hour of life
» Management of neonatal jaundice
» Kangaroo Mother Care Outline of the research gaps
» Prevention of hypothermia immediately after birth in VLBW infants
» Management of children with non-severe pneumonia and wheeze
» Antibiotics for severe pneumonia
» Antibiotics for very severe pneumonia
» Treatment of non-severe pneumonia
» Problems of the neonate and young infant
» Fever Severe malnutrition Hospital Care WHO evidence 0
» Children with HIVAIDS Hospital Care WHO evidence 0
» Common surgical conditions Hospital Care WHO evidence 0
» Supportive care Hospital Care WHO evidence 0
» Monitoring the child’s progress
» Counselling and discharge from hospital
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