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| ''See [[critical care quick reference]] for bolus doses by weight.''
| | #REDIRECT[[Intravenous fluids (main)]] |
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| ==Background==
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| *Total Body Water (TBW) = 0.6 x weight (kg)
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| **Of which, 2/3 is intracellular and 1/3 extracellular
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| ***1/4 of extracellular is vascular
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| ==Maintenance Fluids==
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| ===Adult===
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| *Calculation 1
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| **100 cc/kg/d (4cc/kg/h) 1st 10 kg
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| **50 cc/kg/d (2cc/kg/h) 2nd 10 kg
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| **20 cc/kg/d (1cc/kg/h) each kg > 20
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| *Calculation 2
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| **1500 cc/m2/d (bsa (m2) = sqr rt [wt (kg) x ht (cm)]/3600
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| *Insensible losses = 300-400 cc/m2/d
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| *Adult Standard: D5 0.45%NS at 75-125 mL/hr + 20meq/L of KCl
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| *Deficit: % dehydration x baseline weight
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| *Daily volume needed = maintenance + deficit - fluid already given (i.e. boluses)
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| **Hourly rate daily volume/24 hr
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| ***(or correct 1/2 of deficit in first 8 hr, remainder in next 16)
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| ===Pediatric===
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| *Maintenance fluid default: D5-LR + 20meq/L of KCl or other isotonic solution
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| **Isotonic fluids are now preferred (2019 AAP update)<ref> 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 </ref>
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| ==Electrolytes==
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| *Maintenance Na = 3 mEq/kg/d; K = 2 mEq/kg/d
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| *Deficit = [desired - measured mEq/L] x fD x wt (kg)
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| *fD (distribution factor) Na = 0.6, K = 0.6, Cl = 0.2-0.3, HCO3 = 0.5
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| *(Maintenance + deficit)/daily volume = concentration of electrolyte in fluid to be given
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| *4mL/kg of H2O lost, ups Na by 1meq
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| *Normal saline (NS) = 154 mEq Na/L, 1/2 NS = 77 mEq/L, 1/4NS = 38 mEq/L
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| ==See Also==
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| *[[Intravenous Fluids (Main)]]
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| *[[Critical care quick reference]]
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| == External links ==
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| * [https://www.google.com/search?q=mdcalc+maintenance+fluids&rlz=1C1VDKB_enUS990US990&oq=mdcalc+main&aqs=chrome.0.0i512j69i57j0i390.3894j0j7&sourceid=chrome&ie=UTF-8/ MDCalc maintenance fluids]
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| ==References==
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| <references/>
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| [[Category:FEN]]
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