IV fluid resuscitation: Difference between revisions
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==Electrolytes== | ==Electrolytes== | ||
Maintenance Na = 3 mEq/kg/d; K = 2 mEq/kg/d | *Maintenance Na = 3 mEq/kg/d; K = 2 mEq/kg/d | ||
*Deficit = [desired - measured mEq/L] x fD x wt (kg) | |||
Deficit = [desired - measured mEq/L] x fD x wt (kg) | *fD (distribution factor) Na = 0.6, K = 0.6, Cl = 0.2-0.3, HCO3 = 0.5 | ||
*(Maintenance + deficit)/daily volume = concentration of electrolyte in fluid to be given | |||
fD (distribution factor) Na = 0.6, K = 0.6, Cl = 0.2-0.3, HCO3 = 0.5 | *4mL/kg of H2O lost, ups Na by 1meq | ||
*Normal saline (NS) = 154 mEq Na/L, 1/2 NS = 77 mEq/L, 1/4NS = 38 mEq/L | |||
(Maintenance + deficit)/daily volume = concentration of electrolyte in fluid to be given | |||
4mL/kg of H2O lost, ups Na by 1meq | |||
NS = 154 mEq Na/L, 1/2 NS = 77 mEq/L, 1/4NS = 38 mEq/L | |||
==See Also== | ==See Also== | ||
Revision as of 17:43, 30 November 2022
See critical care quick reference for bolus doses by weight.
Background
- Total Body Water (TBW) = 0.6 x weight (kg)
- Of which, 2/3 is intracellular and 1/3 extracellular
- 1/4 of extracellular is vascular
- Of which, 2/3 is intracellular and 1/3 extracellular
Maintenance Fluids
Adult
- Calculation 1
- 100 cc/kg/d (4cc/kg/h) 1st 10 kg
- 50 cc/kg/d (2cc/kg/h) 2nd 10 kg
- 20 cc/kg/d (1cc/kg/h) each kg > 20
- Calculation 2
- 1500 cc/m2/d (bsa (m2) = sqr rt [wt (kg) x ht (cm)]/3600
Insensible losses = 300-400 cc/m2/d
Adult Standard: D5 0.45%NS at 75-125 mL/hr + 20meq/L of KCl
Deficit: % dehydration x baseline weight
Daily volume needed = maintenance + deficit - fluid already given (i.e. boluses)
Hourly rate daily vol/24 hr
(or correct 1/2 of deficit in first 8 hr, remainder in next 16)
Pediatric
- Maintenance fluid default: D5-LR + 20meq/L of KCl or other isotonic solution
- Isotonic fluids are now preferred (2019 AAP update)[1]
Electrolytes
- Maintenance Na = 3 mEq/kg/d; K = 2 mEq/kg/d
- Deficit = [desired - measured mEq/L] x fD x wt (kg)
- fD (distribution factor) Na = 0.6, K = 0.6, Cl = 0.2-0.3, HCO3 = 0.5
- (Maintenance + deficit)/daily volume = concentration of electrolyte in fluid to be given
- 4mL/kg of H2O lost, ups Na by 1meq
- Normal saline (NS) = 154 mEq Na/L, 1/2 NS = 77 mEq/L, 1/4NS = 38 mEq/L
See Also
External links
References
- ↑ Leonard G. Feld, Daniel R. Neuspiel, Byron A. Foster, Michael G. Leu, Matthew D. Garber, Kelly Austin, Rajit K. Basu, Edward E. Conway, James J. Fehr, Clare Hawkins, Ron L. Kaplan, Echo V. Rowe, Muhammad Waseem, Michael L. Moritz, SUBCOMMITTEE ON FLUID AND ELECTROLYTE THERAPY; Clinical Practice Guideline: Maintenance Intravenous Fluids in Children. Pediatrics December 2018; 142 (6): e20183083. 10.1542/peds.2018-3083