Background

The impact of disorders of fluid balance, including the pathologic state of fluid overload in sick children has become increasingly apparent. With this understanding, there has been a shift from application of absolute thresholds of fluid accumulation to an appreciation of the intricacies of fluid balance, including the impact of timing, trajectory, and disease pathophysiology.

Methods

The 26th Acute Disease Quality Initiative was the first to be exclusively dedicated to pediatric and neonatal acute kidney injury (pADQI). As part of the consensus panel, a multidisciplinary working group dedicated to fluid balance, fluid accumulation, and fluid overload was created. Through a search, review, and appraisal of the literature, summative consensus statements, along with identification of knowledge gaps and recommendations for clinical practice and research were developed.

Conclusions

The 26th pADQI conference proposed harmonized terminology for fluid balance and for describing a pathologic state of fluid overload for clinical practice and research. Recommendations include that the terms daily fluid balance, cumulative fluid balance, and percent cumulative fluid balance be utilized to describe the fluid status of sick children. The term fluid overload is to be preserved for describing a pathologic state of positive fluid balance associated with adverse events. Several recommendations for research were proposed including focused validation of the definition of fluid balance, fluid overload, and proposed methodologic approaches and endpoints for clinical trials.

中文翻译：

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患病儿童的液体评估、液体平衡和液体超负荷：儿科急性疾病质量倡议 (ADQI) 会议的报告

背景

液体平衡紊乱的影响，包括病童液体超负荷的病理状态，其影响已变得越来越明显。有了这种认识，人们已经从应用液体积累的绝对阈值转向了解液体平衡的复杂性，包括时间、轨迹和疾病病理生理学的影响。

方法

第 26 届急性疾病质量倡议是第一个专门针对儿科和新生儿急性肾损伤 (pADQI) 的倡议。作为共识小组的一部分，成立了一个致力于液体平衡、液体蓄积和液体超负荷的多学科工作组。通过对文献的搜索、回顾和评估，制定了总结性共识声明，并确定了知识差距以及对临床实践和研究的建议。

结论

第 26 届 pADQI 会议提出了用于临床实践和研究的液体平衡和描述液体超负荷病理状态的统一术语。建议使用术语“每日液体平衡”、“累积液体平衡”和“累积液体平衡百分比”来描述患病儿童的液体状态。术语“液体超负荷”保留用于描述与不良事件相关的液体正平衡的病理状态。提出了几项研究建议，包括重点验证液体平衡、液体超负荷的定义，以及提出的临床试验方法和终点。