Fifteen-minute consultation: Fluid management in children with cirrhosis

Cirrhosis is a histological description of the liver characterised by widespread disruption of normal liver structure, which becomes distorted with regenerative nodules surrounded by diffuse fibrosis. Patients with cirrhosis are characterised by a unique physiological state with haemodynamic derangements of systemic vasodilation and functional intravascular hypovolaemia. Liver transplantation can be life-saving in children with cirrhosis but their fluid and electrolyte disequilibrium can be difficult to manage. A close, shared-care arrangement between the local hospital and transplant centre is essential in today's climate where there is an ever-increasing number of children on the waiting list. This article aims to provide a concise and pragmatic guide to fluid management in children with cirrhosis.