Fluid and electrolytes
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:
·Congestive heart failure.
failure with oliguria or anuria.