Practical Calculations
Estimate Dehydration
Calculate Total Fluid Intake
Calclulate Daily Caloric Intake
Calculate Urine Output
Components Needed to Calculate
Maintenance
Fluid Deficits
Ongoing Losses
Fluid and electrolyte needs stem from basal metabolism
Creates 2 byproducts: Solute and water
4-2-1 RUle
First 10 kg provide 4 mL/Kg/Hr, Between 10-20, provide 2 mL/Kg/hr, Any above 20 kg provide 1 mL/kg/hr
Causes
Decreased intake (Low appetitie, feeding challenges, lethargy),
Increased losses (Vomiting, diarrhea, increased urine, tubes and drains)
Hypovolemia (Fluid loss from extracellular space exceeds replacements, poor tissue and organ perfusion)
Typically Based on Body weight
Infant: Mild (5%), Moderate (10%), Severe (15%)
Children (>1 year): Mild (3%), Moderate (6%), Severe (10%)
Defitinitions
Mild: Increased thirst, decreased urine output, Tacky mucous membrane
Moderate: Irritable, decreased urine, dry, REduced, mildly delayed cap refill
Severe: Moderate but worse
Urine Output
Expected
Infant: 2-3 mL/kg/hr
Toddler 2mL/Kg/Hr
School Age: 1-2 mL/kg/hr
Adolescent: 0.5-1 mL/Kg/hr
Management
Total Fluid Intake = Maintencance + Deficit + Ongoign loses
Bolus of fluid wiht normal saline
Dextrose containing fluids -> D5W
Infants: 100kcal/kg/Day
Children: (Age in years x 100) + 1000 Kcal/Day
Weight Gain Per day
0-3 months: 25-30 g/day
3-6 months 15-20 g/day
6-12: 10-15 g/day
Calories: 20 Kcal/30 ml in breastmilk/formula