Intravenous fluid guidance for previously well children aged >7 days to 16 years

What's New

20/12/23 Currently there is a supply problem with Plasmalyte & 5% Glucose. If this is unavailable please use 0.9%Saline & 5%Glucose instead

This guidance is under active review & remains compatible with the NICE guidance published in 2022.

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Objectives

This guideline is for use by paediatric medical staff during the administration of MAINTENANCE IV fluid therapy in previously well children aged >7 days to 16 years (separate guidelines available for DKA, burns and NICU). If the patient may have renal impairment, IV fluids must be discussed with the renal team.

Algorithm

1. As per NICE guidelines, routine maintenance fluid prescription should rarely exceed 2L/day for females and 2.5L/day for male patients.

IV fluid constituents

	Plasma	Plasmalyte	Hartmanns	0.9% NaCI	0.18% NaCI 10% Dex	0.45% NaCI 5% Dex
Na⁺mmol/l	135-145	140	131	154	31	77
K⁺mmol/l	3.5-5.3	5	5	-	-	-
CL^-mmol/l	95-105	98	111	154	31	77
HCO₃^-,mmol/l	24-32	27(acetate)	29(Lactate)	-	-	-
Glucose g/l		-	-	-	100	50
Glucose, mmol/l	4-8	-	-	-	556	278
Mg⁺⁺mmol/l	0.8-1.2	1.5	0	0	0	0
Ca⁺⁺mmol	2.2-2.6	-	2	-	-	-
Osmolarity, m0sm/l	280-310	294	277	308	284	406
pH	7.35-7.45	7.4	6.5	5		4.4

Editorial Information

Last reviewed: 04 December 2019

Next review: 30 April 2023

Author(s): Graham Bell

Version: 4

Approved By: Paediatric Clinical Effectiveness & Risk Committee