Fluid maintenance
100% maintenance requirements:
- 100ml/kg/day for first 10kg;
- 50ml/kg/day for next 10 kg;
- 20ml/kg/day for each subsequent kg
Use 0.45% saline/ 5% dextrose or 0.9% saline/ 5% dextrose
Consider potassium needs
- More needed in diarrhoea, salbutamol
- Less needed in post-surgery, renal compromise
In neonates use 10% dextrose. We do not use 10% dextrose with added electrolytes, as we believe this can cause more severe extravasation injuries.
If glucose persistently >12mmol/L, start insulin infusion to aim for 4.4 - 6.1mmol/L
Adjust according to fluid balance and electrolytes.
For some critically ill children it may be appropriate to run 0.9% saline at 75% of requirements: consultant decision
Fluid restriction is not routine in head injury or meningitis - these patients should start on 100% of calculated requirements