[Monitoring fluid balance in pediatric intensive care].

The dynamic metabolism as far as bigger amount of water versus solid tissues in child demand much better skilfulness in calculating liquid input and excretion in intensive care. It is very important fact in prevention of life threatening conditions in children and adults, especially in conditions with multiorganic disorders, because their treatment is reciprocally opposite. Considering experiences of ICU UZ Gent-Belgium we made in Paediatric intensive care unit at Paediatric clinic in Tuzla unique method of monitoring liquid balance in children within specific conditions in which standard method of monitoring just the amount of planed liquid, body weight and diuresis is not reliable enough. With this new monitoring we prescribe dynamics of parenteral input of crystalloid and colloids as well as peroral income much more precise and much more confidence in positive result and prevention of harder disorders as well. In this paper we present our own method of observation as well as results in period July 1999. Till September 2002. We did the intensive volume control in 88 or 45 of total number of 2255 patients treated in PICU in this period. We followed the liquid balance 399 days or 9576 hours. Primary nephrologic diseases were indication for balance in 17 or 19.3% children, while in other 71 or 80.6% children, were other diseases like cardiac failure, diabetic ketoacidosis, chronic systemic diseases, the Toxic shock syndrome, the conditions of intracranial hypertension. We notice the signs of threatening renal failure in 7 or 7.9% of children and signs of manifesting renal failure in 10 or 11.3%. Our experiences tell that the model we made is applicable in working conditions of ICU. Evidence of organism responds the planned input is much better and safer than in standard way of observation. The possibility of in time intervention against threatening renal failure as well as other organic disorders is much greater. We recommended this model for all life threatening conditions in Paediatric intensive care units.