Measure ID
FLUID-02-Peds
Domain
Description

FLUID-02-NC: Percentage of non-cardiac cases in which colloids were not administered intraoperatively.

FLUID-02-C: Percentage of cardiac cases in which colloids were not administered intraoperatively.

Measure Type
Process
Threshold
None
Rationale

There is a lack of consistent evidence to suggest improved survival with the use of colloids as compared to crystalloids in the surgical population. Because colloids are more expensive than crystalloids, it is recommended that anesthesia providers avoid the use of colloids in most instances.

Measure Time Period

Patient In Room to Patient out of Room

Inclusions

FLUID-02-NC: Patients < 18y who undergo a non-cardiac procedure

FLUID-02-C: Patients < 18y who undergo an open cardiac procedure (as defined by the MPOG Cardiac phenotype)

Exclusions
  • Patients ≥ 18 years of age
  • ASA 5 & 6
  • Massive Transfusion or blood loss: Defined as volume of 40mL/kg
  • Procedure Type: Non-operative
  • Patients that are in prone or trendelenburg position for ≥ 4 hours
  • Patients with ascites
Success Criteria

Colloids are not administered during the case.

Provider Attribution

The provider signed in at the time of colloid administration

MPOG Concept Used

Colloids

  • 10018  Albumin 5%
  • 10458  Hetastarch
  • 10459  Pentastarch
  • 10601  Hydroxyethyl Starch 130/0.4 6% in 0.9% Saline (Voluven)
  • 10605  Hydroxyethyl Starch 6% in Lactated Ringers (Hextend)

Patient Position 

  • 50136  Positioning - Patient Position
  • 50137  Positioning - Patient positioned in left lateral decubitus position
  • 50818  Patient positioned in right lateral decubitus position

Blood Administration

  • 10489  Packed Red Blood Cells - Autologous
  • 10490  Packed Red Blood Cells - Homologous
  • 10616  Packed Red Blood Cells - Unknown Type

Patient Diagnosis

  • 10500  Ascites

Estimated Blood Loss (EBL) 

  • 10499  EBL
MPOG Phenotypes Used
References
  1. Bhardwaj N. Perioperative fluid therapy and intraoperative blood loss in children. Indian J Anaesth. 2019;63(9):729-736.
  2. Sümpelmann R, Kretz FJ, Luntzer R, et al. Hydroxyethyl starch 130/0.42/6:1 for perioperative plasma volume replacement in 1130 children: results of an European prospective multicenter observational postauthorization safety study (PASS). Paediatr Anaesth. 2012;22(4):371-378.
  3. Bailey AG, McNaull PP, Jooste E, Tuchman JB. Perioperative crystalloid and colloid fluid management in children: where are we and how did we get here? Anesth Analg. 2010;110(2):375-390.
  4. Riegger LQ, Voepel-Lewis T, Kulik TJ, et al. Albumin versus crystalloid prime solution for cardiopulmonary bypass in young children. Crit Care Med. 2002;30(12):2649-2654.
Measure Authors

 Measure Author

 Institution

 Meridith Wade, MSN, RN

 University of Michigan

 Jay Jeong

 University of Michigan

 MPOG Pediatric Subcommittee

 

 

Measure Reviewer(s)
Next Review: 2025
 Date Reviewed  QC Presentation  Reviewer  Institution  Summary  QC Vote

NA

NA

NA

NA

NA

NA

Version
Published Date: 11/2022
 Date  Criteria  Revision
     None