FLUID REPLACEMENT IN PAEDIATRICS

Source:Tintenelli 6th edition

 FLUID REPLACEMENT IN PAEDIATRICS (NOT IN SHOCK)

 For example, a 12-kg infant is estimated to be 10 percent dehydrated.
 After a 20-mL/kg bolus of NS, she is alert and perfusion is adequate.

Fluid orders can then consist of:

1. Maintenance is 100 mL/kg x 10 kg/24 h = 1000 mL + (50 mL/kg x 2 kg/24 h) = 100 mL, for a total of 1100 mL/24 h or 46 mL per h.

 2. Deficit = 10 percent of body weight (1.2 kg) = 1200 mL; replace 600 mL over the first 8 h or 75 mL per h; replace 600 mL over the next 16 h or 38 mL per h.

Thus, for the first 8 h, maintenance + deficit = 121 mL per h; for the next 16 h, maintenance + deficit = 84 mL per h.

 Appropriate rehydrating solutions in infants are D5 .25NS or D5 .45NS. In infants, D5 .20NS is utilized for maintenance rehydration in isotonic dehydration. In children, D5 .45NS can be used for maintenance rehydration in isotonic dehydration