# Perioperative intravenous fluid management in paediatric surgery: a scoping review protocol

## TL;DR

This study outlines a protocol to map existing evidence on intravenous fluid management in children undergoing non-cardiac surgery.

## Contribution

The protocol introduces a scoping review to synthesize heterogeneous evidence on pediatric perioperative fluid management.

## Key findings

- A scoping review will guide future systematic reviews by mapping evidence on pediatric fluid management.
- The review will include studies on preoperative, intraoperative, and postoperative fluid use in children.
- Findings will be synthesized descriptively without meta-analysis.

## Abstract

Intravenous fluids are essential components of perioperative care, supporting intravascular volume, acid–base balance and electrolyte homeostasis. Despite extensive research in adult surgical populations, paediatric-specific evidence remains limited, and clinical practice frequently relies on extrapolated adult-based recommendations. This gap is particularly relevant in paediatric non-cardiac surgery, where fluid choice may influence key physiological outcomes such as acid–base status, electrolyte balance, renal function and haemodynamic stability. Given the heterogeneity of study designs, perioperative phases, age groups and reported outcomes in the paediatric literature, a comprehensive synthesis of the existing evidence is needed before a systematic review can be undertaken.

We will conduct this scoping review following the methodological guidance of the Joanna Briggs Institute Manual for Evidence Synthesis, and the reporting will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guideline.

This scoping review will map existing evidence on perioperative intravenous fluid management in paediatric patients (<18 years) undergoing elective non-cardiac surgery in outpatient and inpatient settings. Eligible study designs will include randomised trials, observational studies and systematic reviews. A comprehensive search will be developed with a medical librarian and applied to MEDLINE (PubMed), Ovid, Embase, Web of Science, CENTRAL, Google Scholar and ClinicalTrials.gov, with no date restrictions and limited to English, Spanish and German.

Eligibility is framed using participants, concept and context: paediatric patients (<18 years) undergoing non-cardiac surgery; concepts related to preoperative fasting/replacement period, intraoperative period and postoperative period up to 24 hours, intravenous fluid management for maintenance/replacement; and hospital/outpatient surgical settings. Study selection and data charting will follow established scoping review methodology. Data will be synthesised descriptively using narrative and tabular formats. No meta-analysis or formal risk-of-bias appraisal is planned, consistent with scoping review methodology.

This scoping review involves no primary data collection and relies exclusively on published literature; therefore, formal ethical approval is not required. The protocol received administrative approval from the Comité de Ética para la Investigación Científica of Universidad del Cauca (approval no. 6553, 11 June 2025). Findings will be disseminated through peer-reviewed publications, conference presentations and targeted communication with paediatric anaesthesia and surgical communities.