What is the role of fluid resuscitation in the treatment of pediatric appendicitis?

Updated: Oct 25, 2018
  • Author: Adam C Alder, MD; Chief Editor: Carmen Cuffari, MD  more...
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Answer

Ensure adequate hydration for patients who present with suspected appendicitis. Even in early acute appendicitis, children frequently have not had sufficient oral intake and present with some degree of intravascular dehydration. Intravenous hydration often improves abdominal symptoms in children who do not have appendicitis.

Patients with appendicitis usually require fluid boluses prior to operation in order to counteract dehydration. However, these patients need continued fluid resuscitation appropriate to their fluid status and severity of appendicitis.

If fluid status is unclear, urine output is the most common measure. Urine output should be no lower than 0.5 mL/kg/h. If dehydration is suspected, Foley catheter placement, monitoring of urine output, and correct fluid replacement are indicated.

Postoperatively, the spectrum of fluid management ranges from patients with early appendicitis who are started on clear fluids postoperatively and can have intravenous (IV) fluids discontinued when advanced to a regular diet, to patients with perforated appendicitis who require postoperative fluid boluses.


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