Intravenous maintenance fluid therapy (IV-MFT) is one of the most prescribed, yet one of the least studied, interventions in paediatric acute and critical care settings. IV-MFT is not typically treated in the same way as drugs with specific indications, contraindications, compositions, and associated adverse effects. In the last decade, societies in both paediatric and adult medicine have issued evidence-based practice guidelines for the use of intravenous fluids in clinical practice. The main objective of this Viewpoint is to summarise and compare the rationales on which these international expert guidelines were based and how these recommendations affect IV-MFT practices in paediatric acute and critical care. Although these guidelines recommend the use of isotonic fluids as a standard in IV-MFT, some discrepancies and uncertainties remain regarding the systematic use of balanced fluids, glucose and electrolyte requirements, and appropriate fluid volume. IV-MFT should be considered in the same way as any other prescription drug and none of the components of IV-MFT prescription should be overlooked (ie, choice of drug, dosing rate, duration of treatment, and de-escalation). Furthermore, most evidence that was used to inform the guidelines comes from high-income countries. Although some principles of IV-MFT are universal, the direct relevance to and feasibility of implementing the guidelines in low-income and middle-income countries is uncertain.

静脉维持液体治疗 (IV-MFT) 是儿科急症和危重护理环境中最常使用的干预措施之一，但也是研究最少的干预措施之一。IV-MFT 通常的治疗方式与具有特定适应症、禁忌症、成分和相关不良反应的药物不同。在过去的十年中，儿科和成人医学协会都发布了在临床实践中使用静脉输液的循证实践指南。本观点的主要目的是总结和比较这些国际专家指南所依据的基本原理，以及这些建议如何影响儿科急危重症护理中的 IV-MFT 实践。尽管这些指南建议使用等渗液体作为 IV-MFT 的标准，但在系统使用平衡液体、葡萄糖和电解质需求以及适当的液体量方面仍然存在一些差异和不确定性。IV-MFT 的考虑方式应与任何其他处方药相同，并且 IV-MFT 处方的任何组成部分均不应被忽视（即药物的选择、剂量率、治疗持续时间和降级）。此外，用于指导指南的大多数证据来自高收入国家。尽管 IV-MFT 的一些原则是普遍适用的，但在低收入和中等收入国家实施该指南的直接相关性和可行性尚不确定。