Condition Formula IV Fluid

Acute Gastroenteritis

A. Severe Acute Malnutrition (SAM)

source: WHO??

1. In shock 15cc/kg in 15 minutes PLR Antibiotics:

ceftriaxone or
If with improvement but still with shock: 10cc/kg/hr, cefotaxime
start inotropes
Vitamins: zinc, folic,
If with no improvement: stop hydration, consider vitamin A
other causes

2. Not in shock 10cc/kg/hr x 2 hours then reassess until weight RESOMAL Antibiotics and
gain of at least 3% Vitamins

B. Not SAM (Well-nourished)

source: Consensus

1. Hypovolemic shock 20cc/kg in 15-20min PNSS

2. Severe dehydration <10kg: PLR or PNSS

30cc/kg in 30min
70cc/kg in 2 1/2hrs

>10kg:
30cc/kg in 1hr
70cc/kg in 5-6hrs
Condition Formula IV Fluid

3. Moderate/some dehydration ORAL: 75cc/kg in 4 hours ORS

Unable to tolerate ORAL hydration

<10kg: 100cc/kg
>10kg: 60cc/kg

Give as follows:
1/3-1/4 in 1 hour then D5LR or D5 0.45%
2/3-3/4 in 5-6hrs D5 0.3%NaCl

4. Mild dehydration ORAL: ORS

0-2yo: 50-100ml per loose stool
2-10yo: 100-200ml per loose stool
>10yo: as much as tolerated

Unable to tolerate ORAL hydration

<10kg: 50cc/kg
>10kg: 30cc/kg

Give as follows: D5LR or D5 0.45%

1/3-1/4 in 1 hour then D5 0.3%NaCl
2/3-3/4 in 5-6hrs
Condition Formula IV Fluid

Other conditions wherein there is MILD D5LR or D5 0.45% or

dehydration other than acute <10kg: 50cc/kg D5 0.3%NaCl
gastroenteritis >10kg: 30cc/kg
MOD
<10kg: 100cc/kg
>10kg: 60cc/kg
SEVERE
<10kg: 150cc/kg
>10kg: 90cc/kg

give in 24 hours
1st 8 hours: 1/3 MR + 1/2 deficit
Next 16 hours: 2/3 MR + 1/2 deficit

Maintenance Rate Holliday-Segar D5IMB or D5NM and/or

1-10kg. : 100ml/kg depending on electrolyte
11-20kg : 1000ml + 50ml/kg for each kg >10kg values
>20kg. : 1500ml + 20ml/kg for each kg >20kg
*add 20meqs KCL per 1
ADD liter if ill for more than 3
Hyperventilation : 20-30% days and taking nothing
Increased activity : 5-25% per orem, as long as
Hyperthermia : 12% per degree there is adequate urine
celsius increase output

DECREASE
Use of humidified air : 15-30%
Decrease activity : 5-25%
Hypothermia : 5-15%
Sedation : 5-25%

A. Surgical 6-8ml/kg/hr D5LR

B. Cardiac 1000ml/BSA per day or 2/3 MR

if in hypotensive shock: 10ml/kg in 20 min

 Condition Formula IV Fluid

C. Renal 400ml/BSA per day + urine output of previous day

*include drips in calculating total fluids

Source: WHO, Consensus