IV fluid resuscitation: Difference between revisions
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==TBW== | ==TBW== | ||
TBW = 0.6 x weight (kg); 2/3 intra, 1/3 extracellular. 1/4 of extracellular is vascular. | TBW = 0.6 x weight (kg); 2/3 intra, 1/3 extracellular. 1/4 of extracellular is vascular. | ||
==Maintenance== | ==Maintenance== | ||
100 cc/kg/d (4cc/kg/h) 1st 10 kg | #Calculation 1 | ||
##100 cc/kg/d (4cc/kg/h) 1st 10 kg | |||
50 cc/kg/d (2cc/kg/h) 2nd 10 kg | ##50 cc/kg/d (2cc/kg/h) 2nd 10 kg | ||
##20 cc/kg/d (1cc/kg/h) each kg > 20 | |||
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 | Insensible losses = 300-400 cc/m2/d | ||
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(or correct 1/2 of deficit in first 8 hr, remainder in next 16) | (or correct 1/2 of deficit in first 8 hr, remainder in next 16) | ||
==Electrolytes== | ==Electrolytes== | ||
Revision as of 04:39, 14 March 2011
TBW
TBW = 0.6 x weight (kg); 2/3 intra, 1/3 extracellular. 1/4 of extracellular is vascular.
Maintenance
- 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 @ 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)
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
NS = 154 mEq Na/L, 1/2 NS = 77 mEq/L, 1/4NS = 38 mEq/L
Source
7/2/09 PANI