Paediatrics: Fluid and electrolytes

Fluid and electrolytes

Normal fluid requirements

All children with serious acute illness in hospital are given fluid and elec-trolyte solutions. It is important to match what you prescribe to what the child actually needs. There are a number of ways of calculating daily requirements, but the method we most commonly use is based on patient weight.

Normal fluid therapy is based on the above calculations. In the fasting pa-tient, the type of fluid given should contain dextrose (usually 5%), sodium chloride, and added potassium chloride. Outside the neonatal period we use 0.9% or 0.45% saline with dextrose and additives. Do not use plain 5% dextrose in water or 5% dextrose 0.18% saline. The volume of fluid admin-istered should be increased in dehydration, and restricted to 50–75% of the usual maintenance volume in cases of:

·SIADH.

·Fluid overload.

·Congestive heart failure.

·  Renal failure with oliguria or anuria.