Management of Fluids and Electrolytes

Maintenance IV fluids can be written using one of two formulas:

The 4-2-1 Rule is written in mL/hr and is as follows; 4 mL/kg/hr up to 10 kg of body weight, additional 2 mL/kg/hr for each kg above 10 and up to 20 kg, additional 1 mL/kg/hr for each kg above 20 kg body weight.

The Daily Maintenance Fluid Formula for total maintenance IV fluids in a day (which should be divided by 24 to give an hourly rate) is as follows; 100 mL/kg up to 10 kg of body weight, additional 50 mL/kg for each kg above 10 and up to 20 kg, additional 25 mL/kg for each kg above 20.

Daily requirements are 5 mEq/kg/day of sodium, 2 mEq/kg/day of potassium, and 2 mEq/kg/day of calcium. Blood product replacement in pediatrics is by weight. Infant blood volume is 85 mL/kg of body weight

• Platelets 1U/5kg

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