Tuesday 2 May, 2006

“Maintenance” IV fluids in euvolaemic neonates

Posted in Emergency Dept., Michael Tam, Paediatrics, Wards at 12:53 by Michael Tam

Index: Intravenous fluid therapy :: Printer friendly

Original article by: Michael Tam

Baby Beer

Oral intake is always preferable

Neonates (birth to 4 weeks) should be treated as different from other children and have their own needs for fluids. Before you write up fluids for a neonate, you should be asking yourself the following questions:

  1. Why are you writing this up rather than the neonatal team?
  2. Are you actually sure that this neonate is euvolaemic?
  3. Why does this neonate need IV fluids?
  4. Does the neonate have some acute illness or congenital issue that makes “normal” or “usual” fluid management inappropriate?

If you are satisfied that writing up the “maintenance” intravenous fluids is in fact your responsibility, then you can do the following:

1 day old (0 – 48 hours – first two days of life)

  • 0.45% NaCl + 10% dextrose
  • 500 mL bag
  • Rate: 60 mL/kg/day (2.5 mL/kg/hr)
  • Note: Victoria Royal Hospital for Women SCN protocol suggests using 10% dextrose

2 days old:

  • 0.45% NaCl + 10% dextrose + 10 mmol KCl
  • 500 mL bag
  • Rate: 72 mL/kg/day (3 mL/kg/hr)

3 days old to one month:

  • 0.45% NaCl + 10% dextrose + 10 mmol KCl
  • 500 mL bag
  • Rate: 96 mL/kg/day (4 mL/kg/hr)

Updated: Michael Tam (19 June 2006)

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