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Maintenance fluid therapy

Pouring salt on troubled waters

D Taylor, A Durward

Paediatric Intensive Care Unit, Guy’s Hospital, London, UK

Correspondence to:
Correspondence to:
Dr A Durward
Paediatric Intensive Care Unit, 9th floor, Guy’s Tower Block, Guy’s Hospital, St Thomas Street, London SE1 9RT, UK; adurward{at}doctors.org.uk

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The case for isotonic parenteral maintenance solution

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Keywords: hyponatraemia; fluid maintenance; caloric expenditure; 0.9% saline; isotonic

The first 150 words of the full text of this article appear below.

Intravenous fluid and electrolyte therapy for acutely ill children has been a cornerstone of medical practice for well over 50 years. The scientific methodology behind fluid regimens generated much debate in the early 1950s following the pioneering work of Darrow, Talbot, Gamble and others who recognised the important relation between caloric expenditure and requirements for water.^1–3

Caloric expenditure was originally calculated according to body surface area, which at the bedside required either tables or nomograms.¹ In 1957 Holliday and Segar simplified this approach, relating energy expenditure to one of three weight based categories (<10 kg, 10–20 kg, >20 kg).⁴ Electrolyte requirements were also calculated on a weight basis, producing an "ideal", hypotonic solution comprising 0.2% saline in 5% dextrose water (0.18% saline in 4% dextrose in the United Kingdom). This simple regime was subsequently adopted on a global scale and is recommended in current paediatric and medical . . . [Full text of this article]

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This article has been cited by other articles:

• Armon, K, Riordan, A, Playfor, S, Millman, G, Khader, A, for the Paediatric Research Society, (2008). Hyponatraemia and hypokalaemia during intravenous fluid administration. Arch. Dis. Child. 93: 285-287 [Abstract] [Full Text]  
• Cunliffe, M., Potter, F. (2006). Four and a fifth and all that.. Br J Anaesth 97: 274-277 [Full Text]  
• Way, C., Dhamrait, R., Wade, A., Walker, I. (2006). Perioperative fluid therapy in children: a survey of current prescribing practice. Br J Anaesth 97: 371-379 [Abstract] [Full Text]  
• Mann, N P (2004). What routine intravenous maintenance fluids should be used?. Arch. Dis. Child. 89: 411-411 [Full Text]