Fluid Pharmacology or Therapeutic Fluids
Crystalloids can be classified further according to their tonicity. Isotonic, Hypotonic, and Hypertonic Fluids
Balanced Crystalloid Solutions
Fluid distribution across various body water compartments
Effects of Adding Isotonic, Hypertonic, and Hypotonic Saline Solutions to Extracellular Fluid
Volume and Osmolality of Extracellular and Intracellular Fluids in Abnormal States
Maintenance fluids are frequently given through an intravenous line but can also be given orally if the patient is able to tolerate oral therapy. They are made up of insensible and sensible losses
Calculate routine maintenance IV fluid rates for children and young people using the Holliday–Segar formula (100 ml/kg/day for the first 10 kg of weight, 50 ml/kg/day for the next 10 kg and 20 ml/kg/day for the weight over 20 kg). Be aware that over a 24‑hour period, males rarely need more than 2,400 ml and females rarely need more than 2,000 ml of fluids.
The AAP recommends that patients 28 days to 18 years of age requiring maintenance IVFs should receive isotonic solutions with appropriate potassium chloride (KCl) and dextrose because they significantly decrease the risk of developing hyponatremia
Sensible or measurable losses include nasogastric losses or losses from surgical drains and may need ml for ml replacement.
These can lead to dehydration and eventually shock and needs careful assessment and monitoring.
Assessing and monitoring fluid status