Intravenous Fluids


AAP Clinical Practice Guideline reommendations:

The American Academy of Pediatrics recommends that patients 28 days to 18 years of age requiring maintenance IVFs should receive isotonic solutions with appropriate potassium chloride and dextrose because they significantly decrease the risk of developing hyponatremia

Exceptions:
Initial therapy with Hypotonic saline may be considered in the following patients

Fluid
 Glucose (g/dL)
 Sodium
 Chloride
 Potassium (mEq/L)
 Calcium
 Magnesium
 Buffer
 Osmolarity (mOsm/L)
Human Plasma
 0.07 - 0.11
 135 - 145
 95 - 105
 3.5 - 5.3
 4.4 - 5.2
 1.6 - 2.4
 23 - 30
Bicarbonate
 308
D5 0.9% NaCl
Normal Saline (NS)
 5
 154
 154
 0
 0
 0
 0
 308
D5 Lactated Ringer (LR)
 5
 130
 109
 4
 3
 0
 28 Lactate
 273
PlasmaLyte
 0
 140
 98
 5
 0
 3
 27 acetate and 23 gluconate
 294
D5 0.2% NaCl
(1/4 NS)
 5
 34
 34
 0
 0
 0
 0
 78
D5 0.45 NaCl
(1/2 NS)
 5
 77
 77
 0
 0
 0
 0
 154

Osmolality = 2 x Na (mEq/L) + [BUN (mg/dL) / 2.8] + [glucose (mg/dL) / 18]

Potassium - if patient has normal renal function, KCl is added (unless patient has normal K and duration of fluids administration is expected to be brief)
Normal Daily Fluid Requirements
<10kg
 100mL/kg
10-20kg
 1000mL + 50mL/kg for each kg above 10kg
20-80kg
 1500mL + 20mL/kg for each kg above 20kg
>80kg
 2700mL

Fluid Requirement Table
Weight, kg
 Daily mL Hourly mL
1 100 4
2 200 8
3 300 13
4 400 17
5 500 21
6 600 25
7 700 29
8 800 33
9 900 38
10 1000 42
11 1050 44
12 1100 46
13 1150 48
14 1200 50
15 1250 52
16 1300 54
17 1350 56
18 1400 58
19 1450 60
20 1500 63
21 1520 63
22 1540 64
23 1560 65
24 1580 66
25 1600 67
26 1620 68
27 1640 68
28 1660 69
29 1680 70
30 1700 71
31 1720 72
32 1740 73
33 1760 73
34 1780 74
35 1800 75
36 1820 76
37 1840 77
38 1860 78
39 1880 78
40 1900 79
41 1920 80
42 1940 81
43 1960 82
44 1980 83
45 2000 83
46 2020 84
47 2040 85
48 2060 86
49 2080 87
50 2100 88
51 2120 88
52 2140 89
53 2160 90
54 2180 91
55 2200 92
56 2220 93
57 2240 93
58 2260 94
59 2280 95
60 2300 96
61 2320 97
62 2340 98
63 2360 98
64 2380 99
65 2400 100
66 2420 101
67 2440 102
68 2460 103
69 2480 103
70 2500 104
71 2520 105
72 2540 106
73 2560 107
74 2580 108
75 2600 108
76 2620 109
77 2640 110
78 2660 111
79 2680 112
80 2700 113