Prescribing and Preparing Intravenous Fluids in PICU

This guideline is for use by PICU medical and nursing staff during administration of MAINTENANCE IV fluid therapy in non-comorbid children aged > 7 days to 16 years (separate guidelines available for DKA, Diabetes Insipidus, burns (COBIS) & neonates < 7 days old). If the patient has a renal impairment, hypernatraemia ( > 150mmol/l), cardiac failure, recent cardial bypass surgery, metabolic disease, recent neurosurgery, head injury, or other cerebral oedema risk, then IV fluids must be discussed with a PICU Consultant.

IV Fluid Constituents

This guideline is for use by PICU medical and nursing staff during administration of MAINTENANCE IV fluid therapy in unventilated, stable neonates >35 weeks gestation who are aged < 7 days old and are inpatients of PICU.

The standard maintenance fluid to prescribe for these patients is: Plasmalyte & 10% Dextrose (see supplemental monograph on how to prepare this).

If the patient is ventilated, has cardiac failure or renal failure, CNS disease, excessive fluid losses or other potential for electrolyte derangement, please discuss your fluid prescription with a PICU Consultant.

RHC Paediatric Intensive Care Unit: Making alterations to Plasmalyte IV maintenance bags