PICU Fluid administration in cardiac critically ill child

Administrating fluid in children with cardiac disease is a challenging issue in PICU. The vulnerable heart of the ill child needs volume to provide stroke volume and can't tolerate large volume at the same time. Frank Sterling's law remind us that the relative large volume may have adverse effects and disrupt the heart contraction. Left obstructive lesions of heart can't tolerate volume and may lead to pulmonary edema, while Right obstructive lesions can receive more volumes and even sometimes need more fluids to provide stroke volumes.