Intravenous maintenance fluid therapy

For paediatricians of a certain age (including Archivist), their training in intravenous maintenance fluid therapy (IV-MFT) was based on a paper almost 70 years old. (Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics 1957;19:823–32). The recommendations were made from the calculated water requirement based on presumed energy expenditure of healthy breast fed infants. The equations used 1 mL of fluid provided for each kilocalorie expended and the electrolyte concentrations and glucose content of intravenous fluids were estimated to reflect the composition of human and cow’s milk. This standard did not include medically sick children or postsurgical infants and children or those with trauma. A few decades ago, ‘Put up some 4 and a fifth’ (ie, 4% dextrose with 0.18% saline) was a common instruction on general paediatric or surgical wards where these very patients were being managed. Since then, there have been some important...
Source: Archives of Disease in Childhood - Category: Pediatrics Tags: Miscellanea Source Type: research