Guideline on fluid management of acutely ill children

Appropriate and timely fluid and blood management of acutely ill children is a critical and essential area of care. The last review and update of WHO guidelines including fluid management in acutely ill children, occurred in 2016 – six years ago. The 2016 ETAT GDG identified several important questions that were not addressed at that time and additional questions have been raised during the 2022 WHO Wasting guideline process. Furthermore, the 2016 ETAT guideline did not include guidance for care of children up to 12 years of age and the role of blood transfusion was not reviewed. This guideline development process will develop a standard guideline and aims to reflect the most current evidence. Recommendations will be developed on fluid and blood management in acutely ill children, including children with comorbidities, shock, anaemia, wasting with or without nutritional oedema with or without anaemia. The recommendations are intended to provide technical support to Member States on developing and implementing national programmes for appropriate fluid and blood management in acutely ill children aged 2 months to 12 years. The guideline is intended for a wide audience, including health care workers (health professionals including doctors, nurses, intensivists/critical care staff, ambulance staff), policy-makers, their expert advisers and technical/ programme staff at organizations involved in the management of acutely ill children, or developing programmes and policies to manage acutely ill children. The end-users for this guideline will be health care workers / professionals, national and local policymakers, implementers and managers of national and local programs, non-governmental and other organizations and professional societies that develop or implement evidence-based policies, regulations and best practices to best manage fluids and blood in acutely ill children aged 2 months to 12 years. Recommendations will be reflected in WHO tools such as the Pocket Book of Hospital Care for Children.

Disclaimer: In order to enhance its management of conflicts of interest as well as strengthen public trust and transparency in connection with WHO meetings and activities involving the provision of technical/normative advice, the names, and brief biographies of individuals (“Published Information”) being considered for participation in a WHO-convened Guideline Development Group are disclosed for public notice and comment.

The Published Information is provided by the experts themselves and is the sole responsibility of the individuals concerned. WHO is not responsible for the accuracy, veracity and completeness of the provided published information. Furthermore, in no event will WHO be responsible or liable for damages in relation to the use of, and reliance upon, the Published Information.

The comments received by WHO through the public notice and comment process are treated confidentially and their receipt will be acknowledged through a generic email notification to the sender. Any comments should be sent to this e-mail address: [email protected] before 11 November 2022, 12 pm. Comments brought to the attention of WHO through this process are an integral component of WHO’s conflict of interest assessment process and are carefully reviewed. WHO reserves the right to discuss information received through this process with the relevant expert and disclose to this expert the name and affiliation of the provider of such information. Upon review and assessment of the information received through this process, WHO, in its sole discretion, may take appropriate management action in accordance with its policies.

Guideline Development Groups provide technical and/or normative advice and recommendations to WHO. Participation in a Guideline Development Group convened by WHO does not necessarily mean that the views expressed by the expert concerned are shared by WHO and/or represent the decisions or stated policy of WHO. The list of participating experts, a summary of relevant interests disclosed by such experts, and any appropriate mitigation measures taken by WHO relating to the management of conflicts of interests, will be reported publicly in accordance with WHO policies.

/Public Release. View in full here.