Pediatric Fluid Management

• Maintenance Fluids
• First 10 kg: 4 cc/kg/hr
• Second 10 kg: 2 cc/kg/hr
• Each additional kg: 1 cc/kg/hr
• IV FLUID BOLUS = 10 cc/kg NS or LR
• NG Replacement
• D5LR = 5 meq KC1/250 cc or D5  ½ NS = 5 meq KC1/250 cc
• Replace losses cc for cc every four hours
• Nutrition
• Caloric requirements 110-150 cal/kg/day
• Formula: Isomil, Similac, etc. 20 cal/30 cc (0.66cal/cc)
• Hyperalimentation
• Central D25: 0.95 cal/cc
• Peripheral D10: 0.40 cal/cc
• Intralipid 10%: 1.1 cal/cc
• Intralipid 20%: 2.2 cal/cc
• Transfusions
• PRBC’s or FFP: 10 cc/kg dose
• 25% albumin: 4 cc/kg/dose
• Blood volume (HCT desired-HCT present) divided by HCT transfused blood = volume to transfuse
• PRBC’s HCT = 65
• Blood volume = approx 80 cc/kg for weight up to 10 kg
• Approx 60-70 cc/kg for weight >10 kg