Fluids
Whole body fluids = ICF + ECF (IVF +EVF)
Neonate have great ECF:ICF ratio
Therefore dehydrate more quickly than over 1yo (45:55%)
Children higher H2O:wt than adults 80% > 60%
Na concentration is higher in ECF than ICF
K is higher in ICF than ECF
Normal
Fasting
Gastro (no low Na fluids > cerebral oedema, no K until passed urine)
Special
DKA
Renal failure
Shock Bolus
Burns
Sticker, wt and allergies
Date, time, type, volume, rate, sign, name
Maintenance
Preterm
D1 60ml/kg/day
D2 80ml/kg/day
D3 100ml/kg/day
D4 150ml/kg/day
Term
D1 2.5ml/kg/hr (60ml/kg/day)
D2 3.7ml/kg/hr (90ml/kg/day)
D3-30 5ml/kg/hr (120ml/kg/day)
>1m
4ml/kg/hr for 1st 10kg (100ml/kg/day)
2 (50)
1 (25)
Deficit (don't replace more than 5% over 24 hours)
Wt x percent dehydration x 10 /24 for /hr replacement
Na (140mmol/L) requirements 2-3mmol/kg/day
K 4mmol/L req 1-3mmol/kg/day
500ml bags
Plasma osmol
10%dextrose (only for maintenance in first days of life: Glucose 556mmol/L = 556mOsmol, 1600kJ/L)
0.9% dextrose (boluses: Na 150mmol/L, Cl 150mmol/L = 300mOsmol, OkJ/L)
References:Learn Paediatrics Orientation Module
Neonate have great ECF:ICF ratio
Therefore dehydrate more quickly than over 1yo (45:55%)
Children higher H2O:wt than adults 80% > 60%
Na concentration is higher in ECF than ICF
K is higher in ICF than ECF
Normal
Fasting
Gastro (no low Na fluids > cerebral oedema, no K until passed urine)
Special
DKA
Renal failure
Shock Bolus
Burns
Sticker, wt and allergies
Date, time, type, volume, rate, sign, name
Maintenance
Preterm
D1 60ml/kg/day
D2 80ml/kg/day
D3 100ml/kg/day
D4 150ml/kg/day
Term
D1 2.5ml/kg/hr (60ml/kg/day)
D2 3.7ml/kg/hr (90ml/kg/day)
D3-30 5ml/kg/hr (120ml/kg/day)
>1m
4ml/kg/hr for 1st 10kg (100ml/kg/day)
2 (50)
1 (25)
Deficit (don't replace more than 5% over 24 hours)
Wt x percent dehydration x 10 /24 for /hr replacement
Na (140mmol/L) requirements 2-3mmol/kg/day
K 4mmol/L req 1-3mmol/kg/day
500ml bags
Plasma osmol
10%dextrose (only for maintenance in first days of life: Glucose 556mmol/L = 556mOsmol, 1600kJ/L)
0.9% dextrose (boluses: Na 150mmol/L, Cl 150mmol/L = 300mOsmol, OkJ/L)
References:Learn Paediatrics Orientation Module