## How do you calculate pediatric fluid replacement?

- 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 IV fluid rate for pediatrics?

- Daily fluid requirements.
- Fluid requirements per hour: Daily fluid requirements are divided into approximate hourly rates which gives the “4-2-1” formula often used to calculate hourly infusion rates of IV fluids.
- Example: A 35 kg child minimum hourly fluid intake would be: (4×10) + (2×10) + (1×15) = 75 cc/hour.
- Table 2.

**What maintenance fluids do pediatrics use?**

Treatment. The AAP recommends the use of isotonic solutions with adequate potassium chloride and dextrose for maintenance IV fluids in children; this recommendation significantly reduces the risk of hyponatremia without increasing other risks, including hypernatremia and acidosis.

### What is the 4 2 1 rule for maintenance fluids?

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.

### How are pediatric doses calculated?

Most drugs in children are dosed according to body weight (mg/kg) or body surface area (BSA) (mg/m2). Care must be taken to properly convert body weight from pounds to kilograms (1 kg= 2.2 lb) before calculating doses based on body weight.

**How do you calculate pediatric dehydration rate?**

After clinical signs have been observed, the degree (%) of dehydration should be determined. This is calculated by dividing the difference between the pre-illness and illness weights by the pre-illness weight, then multiplying by 100 (Table 5). For example, a 10-kg patient who has lost 1 kg is 10% dehydrated.

#### 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.

#### What is Clark’s rule formula?

Clark’s rule equation is defined as the weight of the patient in pounds divided by the average standard weight of 150 pounds (68 kg) multiplied by the adult dose of a drug equals the pediatric medication dose, as is demonstrated below: (Weight* divided by 150 lbs.) x Adult Dose** = Pediatric Dosage.

**What is Fried’s rule?**

Fried’s rule is a method of estimating the dose of medication for a child by dividing the child’s age in months by 150 and multiplying the result by the adult dose. Pediatric dose = child’s age in months. 150. x Adult Dose.

## How much IV fluid is given for dehydration?

If hydration is not improving, give fluids more rapidly; the patient may need 200 ml/kg or more of intravenous fluids during the first 24 hours of treatment. You can decrease the amount of fluid if the patient becomes hydrated earlier than expected.

## What are typical pediatric IV fluids?

Bolus fluids should be isotonic; either normal saline or lactated ringers solution is used at a volume of 20 mL per kg, given over 60 minutes. Repeat boluses are given if necessary to maintain adequate perfusion. Isotonic fluids are used because they provide rapid volume expansion in the plasma and extracellular fluid.