Intravenous fluid therapy: Difference between revisions
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{{Adult top}} [[Intravenous fluid therapy (peds)]] or [[critical care quick reference]] for bolus doses by weight.'' | |||
==Background== | |||
{{IVF composition}} | |||
{{Total body water}} | |||
==Acute Repletion (Bolus)== | |||
*Typically 20-mL/kg aliquots of isotonic (e.g., NS or LR) fluid | |||
==Maintenance Fluids== | |||
*Insensible losses = 300-400 cc/m2/d | |||
*Adult Standard: D5 0.45%NS at 75-125 mL/hr + 20meq/L of KCl | |||
*Deficit: % dehydration x baseline weight | |||
*Daily volume needed = maintenance + deficit - fluid already given (i.e. boluses) | |||
**Hourly rate daily volume/24 hr | |||
***(or correct 1/2 of deficit in first 8 hr, remainder in next 16) | |||
== | ==Electrolytes== | ||
*Maintenance Na = 3 mEq/kg/d; K = 2 mEq/kg/d | |||
*Deficit = [desired - measured mEq/L] x fD x wt (kg) | |||
*fD (distribution factor) Na = 0.6, K = 0.6, Cl = 0.2-0.3, HCO3 = 0.5 | |||
*(Maintenance + deficit)/daily volume = concentration of electrolyte in fluid to be given | |||
*4mL/kg of H2O lost, ups Na by 1meq | |||
==See Also== | ==See Also== | ||
*[[Critical care quick reference]] | |||
*[[Vascular access]] | *[[Vascular access]] | ||
*[[Electrolyte abnormalities]] | |||
==External Links== | ==External Links== | ||
* [https://www.mdcalc.com/calc/72/maintenance-fluids-calculations MDCalc maintenance fluids] | |||
*http://www.aliem.com/paucis-verbis-composition-of-intravenous-fluids/ | *http://www.aliem.com/paucis-verbis-composition-of-intravenous-fluids/ | ||
Latest revision as of 19:51, 12 June 2024
This page is for adult patients. For pediatric patients, see: Intravenous fluid therapy (peds) or critical care quick reference for bolus doses by weight.
Background
Composition of Different Intravenous Fluids
| Fluid [1] | Osm | Na | Cl | Glucose(g/L) | pH | Buffer | K | Ca | Mg |
|---|---|---|---|---|---|---|---|---|---|
| Plasma | 289 | 140 | 103 | 7.4 | HCO3 22-32 | 4 | 5 | 2 | |
| Normal Saline (NS) | 308 | 154 | 154 | 0 | 5.0 | 0 | 0 | 0 | 0 |
| D5NS | 560 | 154 | 154 | 50 | 0 | 0 | 0 | ||
| Lactated Ringers | 273 | 130 | 109 | 0 | 6.5 | Lactate 28 | 4 | 3 | 0 |
| Plasmalyte | 295 | 140 | 98 | 0 | 5.0 | Gluconate 23/Acetate 27 | 5 | 0 | 3 |
| D5 1/2NS | 406 | 77 | 77 | 500 | 4.5 | 0 | 0 | 0 | 0 |
| D5W | 252 | 0 | 0 | 50 | |||||
| 5% Albumin | 309 | 130-160 | 130-160 | 6.4-7.4 | <1 |
Total Body Water
- Total Body Water (TBW) = 0.6 x weight (kg)
- Of which, 2/3 is intracellular and 1/3 extracellular
- 1/4 of extracellular is vascular
- Of which, 2/3 is intracellular and 1/3 extracellular
Acute Repletion (Bolus)
- Typically 20-mL/kg aliquots of isotonic (e.g., NS or LR) fluid
Maintenance Fluids
- Insensible losses = 300-400 cc/m2/d
- Adult Standard: D5 0.45%NS at 75-125 mL/hr + 20meq/L of KCl
- Deficit: % dehydration x baseline weight
- Daily volume needed = maintenance + deficit - fluid already given (i.e. boluses)
- Hourly rate daily volume/24 hr
- (or correct 1/2 of deficit in first 8 hr, remainder in next 16)
- Hourly rate daily volume/24 hr
Electrolytes
- Maintenance Na = 3 mEq/kg/d; K = 2 mEq/kg/d
- Deficit = [desired - measured mEq/L] x fD x wt (kg)
- fD (distribution factor) Na = 0.6, K = 0.6, Cl = 0.2-0.3, HCO3 = 0.5
- (Maintenance + deficit)/daily volume = concentration of electrolyte in fluid to be given
- 4mL/kg of H2O lost, ups Na by 1meq
See Also
External Links
References
- ↑ Paucis Verbis: Composition of intravenous fluids. http://www.aliem.com/paucis-verbis-composition-of-intravenous-fluids/ Published January 3, 2013. Accessed August 29, 2015