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Fluid in Paediatrics Patients

The document outlines fluid maintenance guidelines for pediatric patients, detailing daily fluid requirements based on various medical conditions. It includes specific recommendations for neonates and malnourished children, emphasizing the importance of careful rehydration methods. Additionally, it provides criteria for different treatment plans based on the severity of dehydration and other complications.

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mirembe precious
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49 views16 pages

Fluid in Paediatrics Patients

The document outlines fluid maintenance guidelines for pediatric patients, detailing daily fluid requirements based on various medical conditions. It includes specific recommendations for neonates and malnourished children, emphasizing the importance of careful rehydration methods. Additionally, it provides criteria for different treatment plans based on the severity of dehydration and other complications.

Uploaded by

mirembe precious
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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FLUID IN PAEDIATRICS

PATIENTS
MAINTENANCE FLUID
• Sick patient with
Reduce intake
Increase output

• Daily necessities: 1500ml – 2000/m2BSA/24hrs


How to calculate
• Severe bacterial infection: 1500 - 2000ml/m2/24hrs
• Heart failure: 800ml/m2/24hrs
• Respiratory diseases: 1000ml/m2/24hrs
• Nervous infection: 1000ml/m2/24hrs
• Vaso-occlusive crises of sickle cell disease:
2000ml/m2 /24hrs
• Poisoning: 2000ml/m2 /24hrs
Type of maintenance fluids in
Paediatrics patients
• 5% Dext or 10% Dext (in mal nutrition patients)
½ part
• Normal Saline solution ½ part + 5% Dextrose ½
part
• K: 40 meq/m2/24hrs (amps 25.5meq-10ml)
• Drip or dripping: Total of fluids/#Hrsx3(constant)
Type of maintenance fluids in
neonates
Day Dose
1 70ml/kg/day
2 70-80ml/kg/day
3 80-90ml/kg/day
4 90-100ml/kg/day
5 100-120ml/kg/day
6 and more 120-150ml/kg/day
Type of maintenance fluids in
neonates
10% Dext
• Na: 3meq/kg/day after 48 hrs (amps 34meq-
10ml) and (75.5meq-20ml)
• K: 3 meq/kg/day after 72 hrs (25.6meq-10ml)
• Ca: 200mg/kg/day after 24 hrs (amp 100mg-iml)
• Mg: 50mg/kg/day after 24 hrs (amp 1g-10ml)
PLAN A
•50-100ml/ motion infant-2years
•100-120ml/ motion 3 years- 5 years
•120-200ml/motion 6 years- 10 years
•Free, above 10 years
Plan B
•75-100ML/Kg/ 6 or 4 hours
CRITERIA OF PLAN C
•Severe dehydration
•Shock
•Loss consciousness
•Paralytic Ilion
CRITERIA OF PLAN C
• Profuse vomiting (When the patient lose
more than 4 ml of water through vomiting)
• Profuse diarrhea ( when the patient lose
more than 10 ml/kg/hr of water through
diarrhea)
• Convulsion
PLAN C
• Good nutritional status
Below 1 year
6 hours For the first hour 30ml/kg
For the rest 5 hours 70ml/kg
1 year and above
3 hours For the first 30 minutes 30ml/kg
For the rest 2 ½ hours 70 ml/kg
Malnourished
• Do not use IV route for rehydration, except in cases of
shock
• Rehydrate slowly, either orally or by NGT using
ReSoMal, a specially prepared rehydration solution for
malnutrition, the standard ORS has a high sodium and
low potassium content, which is not suitable for SAM,
except if profuse diarrhoea is present
ReSoMAL
• Give 5ml/kg every 30 minutes for the first 2
hours
• Then give 5-10 ml/kg per hour for the next
4-10 hours, with F-75 formula. Exact
amount depends on how much the child
wants, the volume of stool loss and whether
the child is vomiting
PARENTERAL TREATMENT
• If the child is unconscious or in shock
• Give IV fluid
Darrow’s solution + 5% Dextrose ½ and ½
Ringer’s lactate + 5% Dextrose ½ and ½
Normal saline + 5% Dextrose ½ and ½
At 15ml/kg the first hour and reassess
PARENTERAL TREATMENT
CONT…..
• If improving, give 15ml/kg in second hour

• If not improving, treat for septic shock


REFERENCES
UGANDA
CLINICAL
GUIDELINES Prof. Melvis Bernis
2016

NATIONAL GUIDELINES FOR MANAGEMENT OF COMMON


CONDITIONS

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