Intravenous Fluid Management
Note: The following guidelines are for maintenance intravenous fluid in a well hydrated child. For assistance with fluid management of a child with dehydration, electrolyte disturbances, or unusual fluid losses, please consult the on-call pediatrician at 301-496-1211.
Volume
Volume: Daily Maintenance
|
Patient's Weight Range |
Maintenance Fluids needed per 24 hours |
|
if 10 kg or less |
Pt. needs 100 mL for each kg |
|
if 10 kg or less |
Pt. needs 1000 mL PLUS 50 mL for each kg over 10 |
|
if more than 20 kg |
Pt. needs 1500 mL PLUS 20 mL for each kg over 20 |
Examples:
- 15 kg child: maintenance = 1250 mL/ 24 hours
- 25 kg child: maintenance = 1600 mL/ 24 hours
Volume: Hourly Rate
– Divide daily maintenance by 24 or use "4:2:1 rule"
|
Patient's Weight Range |
Hourly maintenance fluid rate |
|
if 10 kg or less |
Pt. needs 4 mL/hr. for each kg |
|
if 11-20 kg |
Pt. needs 40 mL/hr. PLUS 2 mL/hr. for each kg over 10 |
|
if more than 20 kg |
Pt. needs 60 mL/hr. PLUS 1 mL/hr. for each kg over 20 |
Examples:
- 15 kg child: maintenance = 50 mL/hour
- 25 kg child: maintenance = 65 mL/hour
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Fever
Increase maintenance volume or rate by 10-15% for each degree Celsius over 38
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Electrolytes in Maintenance Fluids
|
Electrolyte |
Recommended Amount |
|
Sodium |
3 meq/100 cc fluid |
|
Potassium |
2meq/100cc fluid |
|
Glucose |
5 gm/100cc fluid |
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Recommended Maintenance Fluids
|
Patient's Weight Range |
Recommended Maintenance Fluids |
|
if less than 30 kg |
Pt. needs D5 0.2%NaCL (1/4 NS) + potassium (see below) |
|
if 30 kg or more |
Pt. needs D5 0.45%NaCl (1/2 NS) + potassium (see below) |
Potassium (for either fluid):
20 mEq KCl for every 1000 mL. Maximum 40 mEq/ 1000 mL. If needed for a child with acidosis, use K Acetate.
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This information is prepared specifically for caregivers involved in clinical research at the NIH Clinical Center at the National Institutes of Health.
