How to calculate IV fluid therapy in children (maintenance + deficit)

Learn how to calculate intravenous maintenance and deficit fluid requirements in children. Hear all about the Holliday-Segar formula. We'll cover: calculating 24 hourly and hourly fluid requirements; calculating the fluid deficit; choice of fluids; when to reduce from full maintenance; and adding electrolytes.
0:00 Intro
1:23 Calculating 24 hourly fluid requirements
2:02 Example of calculating the 24 hourly requirement
2:44 Calculating hourly fluid requirements
3:07 Example of calculating the hourly requirement
3:56 Calculating fluid deficit
5:53 Example of calculating fluid deficit
5:54 Top tip 1: fluid choice
6:23 Top tip 2: should you restrict the maintenance fluids?
7:07 Top tip 3: adding electrolyte
Here are some helpful references:
NICE algorithm for IV fluid therapy in children and young people in hospital: www.nice.org.uk/guidance/ng29...
Royal Children's Hospital Melbourne, Clinical Practice Guidelines: intravenous fluids: www.rch.org.au/clinicalguide/...

[@walaaqasim9010]

Thanks so much this was very helpful!

[@natnaelpaulos2205]

Thank you very much🎉

[@mahmoodgherbali594]

Thank you very much .

[@giftdouglas6274]

Thank you so much

[@lavida49]

Thanks a lot 💜

[@user-fw7rw5rk1c]

thank you so so so so so much

[@user-sl7dk1jk8m]

Thanks so much , how do we calculate deficit based on hours of not eating, ex. For anesthesia !?

[@Dontforgetthebubbles]

Fasting for anaesthetic wouldn’t be a deficit. Its just the maintenance requirement. Hope that helps. ~Tessa

[@user-sl7dk1jk8m]

@@Dontforgetthebubbles thanks again

[@arsenaldream2156]

Thank you so much. So the preferred fluid to be used is N/S 0.9%in Dex 5% in cases of acute gastroenteritis. So I wanted to ask you is it possible to add the amount of ongoing losses for example the child vomited 4 times and had 3 loose motion in the past 6 to 8 hours, is it OK to add 50 ml for each time he had vomiting or diarrhea for child less than 2 years and 100 ml for each time child more than 2 years of course the total will be divided by 12h or 24 hours. So the total fluid the child receives (deficit + maintenance + ongoing loss) /hr?
One last question and I really hope to get an answer to that as well
Most of the times parents don't want to stay more than an hour for fluid and it's challenging to get them to understand that it has to be done certain way but they don't have the patience and sometimes there might come way sever cases and needed to be looked after and there are limited beds in the facility that I work in, what would be the best solution to get the child at least the minimum so when they are discharged at least they will be in good position to go on with enteral fluid. Sorry for long questions I hope to get your. Valuable opinion

[@Dontforgetthebubbles]

Hi - we don’t normally calculate losses in that way, instead we clinically assess the % dehydration and add this on as the deficit. Hope that helps. ~Tessa

[@arsenaldream2156]

@@Dontforgetthebubbles how much percent will be count for each kilogram loss?
Is it possible to give iv fluids over an hour with anti emetic if there is vomiting and send the patient home with ORS and if the child improve with the next hours in term of ability to contain fluid or if the child still not accepting the ORS the child brought back to hospital. Do you think that's acceptable approach

[@samuelthaddeus4950]

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