In management of pediatric heart failure, which intervention should be used with caution due to risk of fluid overload?

• A. Oxygen therapy
• B. IV fluids
• C. Diuretics
• D. Inotropic medications

Answer: (B)

In pediatric heart failure, keeping fluid balance under control is crucial because the heart already struggles to pump effectively. Intravenous fluids raise preload by increasing intravascular volume, which can worsen edema and pulmonary congestion and tip a patient into fluid overload. That’s why IV fluids should be used with great caution or avoided when signs of volume overload are present.

Oxygen helps with gas exchange but doesn’t directly affect fluid status. Diuretics are used to remove excess fluid and reduce preload, addressing the overload. Inotropic medications improve contractility and cardiac output, which can help perfusion without inherently causing fluid overload, though they require careful monitoring.