What is the 421 rule?

In anesthetic practice, this formula has been further simplified, with the hourly requirement referred to as the “4-2-1 rule” (4 mL/kg/hr for the first 10 kg of weight, 2 mL/kg/hr for the next 10 kg, and 1 mL/kg/hr for each kilogram thereafter.

When should I give my child maintenance fluids?

Maintenance fluids are given over 24 hours and calculated by the weight using the Holliday-Segar formula for children >28 days of age, or by weight and age in neonates. Replacement fluids are required where there is an existing fluid deficit and evidence of clinical dehydration on examination.

Why maintaining fluid balance is critical in pediatric?

In children, maintaining adequate fluid intake and optimal hydration is essential for physiological and behavioral reasons. Water is the most abundant component of the human body. In newborns, who have developed in an aqueous milieu, body water content at birth is approximately 75% of body mass [1].

What IV fluid is most appropriate for a maintenance fluid for a pediatric patient?

For most children, a 5% dextrose solution with 0.2% sodium chloride provides the estimated needs of sodium when used as a maintenance fluid.

How do you calculate maintenance fluid in pediatrics?

For infants 3.5 to 10 kg the daily fluid requirement is 100 mL/kg.
For children 11-20 kg the daily fluid requirement is 1000 mL + 50 mL/kg for every kg over 10.
For children >20 kg the daily fluid requirement is 1500 mL + 20 mL/kg for every kg over 20, up to a maximum of 2400 mL daily.

How do you calculate fluid maintenance?

Formulas Used:

For 0 – 10 kg = weight (kg) x 100 mL/kg/day.
For 10-20 kg = 1000 mL + [weight (kg) x 50 ml/kg/day]
For > 20 kg = 1500 mL + [weight (kg) x 20 ml/kg/day]

How do pediatrics choose IV fluids?

Calculate routine maintenance IV fluid rates for term neonates according to their age, using the following as a guide:

From birth to day 1: 50–60 ml/kg/day.
Day 2: 70–80 ml/kg/day.
Day 3: 80–100 ml/kg/day.
Day 4: 100–120 ml/kg/day.
Days 5–28: 120–150 ml/kg/day.

How do you prepare maintenance fluid in pediatrics?

Why is fluid important for children?

Water serves numerous vital functions such as maintaining cell structure, waste removal, and distribution of nutrients, oxygen and immune cells. Water also plays a leading role in stabilising body temperature. Hydration has been associated with energy levels and physical endurance, as well as concentration and focus.

What are maintenance IV fluids?

Maintenance IV fluids are appropriate for euvolemic medical and surgical patients who cannot take adequate enteral fluids. “Maintenance” = volume of fluid required to meet daily metabolic needs, such as normal water and electrolyte losses, and maintain homeostasis.