Barriers and opportunities to improve fluid balance recognition and reduction: a qualitative study
By
Chloe Braun
Celeste G. Dixon
Ami J. Shah
Adam Dziorny
Julie C. Fitzgerald
Susan Martin
James Odum
Melissa Ryan
Samantha Whitfield
Lori B. Bateman
Denise C. Hasson
June 11, 2026
Clinical Scorecard: Challenges and prospects for enhancing the identification and management of fluid balance: a qualitative investigation
At a Glance
Category Detail
Condition Excess cumulative fluid balance in critically ill pediatric patients Key Mechanisms Fluid accumulation impacts morbidity and mortality; assessment relies on patient weight and documented intake/output. Target Population Critically ill pediatric patients in pediatric intensive care units (PICUs) Care Setting Pediatric intensive care units (PICUs)
Key Highlights
Excess cumulative fluid balance is linked to worse clinical outcomes. Inconsistent practices in recognizing and reducing fluid balance exist. Cultural barriers and educational gaps hinder effective fluid management. Accurate data reporting and standardization are needed for better outcomes. Interventions for fluid balance management are not standardized. Guideline-Based Recommendations
Diagnosis
Accurate assessment of fluid balance is essential, relying on patient weight and documented intake/output. Management
Limit unnecessary fluid administration and improve recognition of fluid accumulation. Monitoring & Follow-up
Regularly assess fluid balance to prevent excess accumulation. Risks
Excess fluid balance is associated with increased morbidity and mortality. Patient & Prescribing Data
Critically ill pediatric patients in PICUs
Fluid management practices vary significantly across institutions.
Clinical Best Practices
Implement standardized protocols for fluid balance assessment. Enhance communication among multidisciplinary teams regarding fluid management. Provide education to healthcare providers on the importance of fluid balance. Related Resources & Content
