Maint + Deficit Fluids - Pediatrics
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Patient Weight
unit kg lb
% Dehydration
R e s u l t s
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Maint + Deficit Fluids - Pediatrics

Maintenance fluid therapy is essential for replacement of lost water and electrolytes

Maintenance fluid requirement can be calculated based on the metabolic rate and energy expenditure of patients.

Holiday and Seger categorized energy expenditure in infants and children into three weight categories as follows:

  • 1-10 kgs: 100 cal/kg
  • 11-20 kgs: 50mLcal/kg
  • >=21 kgs: 20 cal/kg

In patients with acute dehydration, acute weight loss accounts for fluid deficit. If exact weight loss is not known, the volume of fluid deficit may be calculated on the basis of severity (%) of dehydration.

Formula:

Determined w/ body weight method:

Maintenance

  • 1st 10 kg's: 100mL/kg/24hr
  • 2nd 10 kg's: 50mL/kg/24hr
  • Add'l kg's: 20mL/kg/24hr

Deficit(mL)=Wt(in kg) * % Dehydr

% Dehydr estimate from % weight loss
Mild Moderate Severe
Infant 5% 10% 15%
Child 3-4% 6-8% 10-12%

Stable, no hyperNa: replace ½ total fluids first 8hrs, rest next 16hrs.

Need additional fluids for ongoing losses

References:

  • Hines EQ. Fluid and Electrolytes. In: Tschudy MM, Arcara KM, eds. The Harriet Lane Handbook. 19th ed. Philadelphia, PA: Elsevier Mosby; 2012:271-292.
  • Siegel NJ, Carpenter TO, Gaudio KM. Fluid and Electrolyte Management. In: Crocetti M, Barone MA, eds. Oski's Essential Pediatrics. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2004:18-21.