IDAME SIVI ELEKTROLIT TEDAVISI.pdf

Selection of Maintenance Fluids
After calculation of water needs and electrolyte needs,
children typically receive either D5 ¼ NS +
20mEq/L KCl or D5 ½ NS +
20mEq/LKCl. Children weighing less than
about 20–25 kg do best with the
solution containing 1/4 NS because of
their high water needs per kilogram. In
contrast, larger children and adults
may receive the solution with ½ NS.
These guidelines assume that there is no disease
process present that would require an adjustment in
either the volume or electrolyte composition of
maintenance fluids (e.g., children with renal
insufficiency may not tolerate 20mEq/L of
potassium). These solutions work well in children
who have normal homeostatic mechanisms for
adjusting urinary excretion of water, sodium, and
potassium. In children with complicated
pathophysiologic derangements, it may be necessary
to empirically adjust the electrolyte composition and
rate of maintenance fluids based on electrolyte
measurements and assessment of fluid balance.