Paediatric fluid management

Fluid requirements = Maintenance + Ongoing Losses + Deficit

Maintenance requirements

4ml/kg/hr (First 10kg)
+ 2ml/kg/hr (Next 10kg)
+ 1ml/kg/hr (every kg thereafter)

= 3% dextrose and 1/3 N saline + 20 mmol/L KCL

e.g.

8kg infant	8kg	x	4ml/kg/hr	= 32ml/hr
			Total	= 32ml/hr

16kg child	First 10kg	x	4ml/kg/hr	= 40ml/hr
	Next 6kg	x	2ml/kg/hr	= 12ml/hr
			Total	= 52ml/hr

22kg child	First 10kg	x	4ml/kg/hr	= 40ml/hr
	Next 10kg	x	2ml/kg/hr	= 20ml/hr
	Next 2kg	x	1ml/kg/hr=	= 2ml/hr
			Total	= 62ml/hr

Ongoing losses

2ml/kg/hr (if rotavirus)

= 1/2 NS + 10mmol/L KCl

Deficit

Deficit = % dehydration x weight (see assessing degree of dehydration)
Replace over 24-48hrs

NB if significant electrolyte derangement then consult senior for modifications to fluid management