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CALCULATION
OF FLUID
REQUIREMETS
IN NEONATES
Presented by:
vruti patel
TOTAL BODY WATER
• 0.7 L/Kg in newborn
• 0.6 L/Kg at 1 year age
• ECF – 40% newborn
20% older children
 Who required fluid ?
 Infant <30 wks. & <1250 gm
 Sick term neonates
 Severe birth asphyxia
 Apnea
 RDS
 Sepsis
Who required fluid ?
HOW MUCH FLUID TO BE GIVEN ?
<1 kg 1-1.5 kg > 1.5 kg
1st
day 100 mi/kg 80 ml/kg 60 ml/kg
7th
day 190 ml/kg 170 ml/kg 150 ml/kg
• Increase 15 ml/kg/day up to 6th
day
• Add 20 ml/kg/day for phototherapy & warmer
• All calculation done on birth weight till body weight exceeds birth weight
WHAT FLUID ?
1st 48 hrs. <1 kg 5% Dextrose
1-1.5 kg 10% Dextrose
>1.5 kg 10% Dextrose
After that ISO - P
ELECTROLYTES REQUIRREMENT
A. SODIUM
 add – from day 2-3
 In VLBW add when lost 6% weight
 Require term and LBW 2-3 mEq/kg/day & ELBW 3-5
mEq/kg/day
B. POTASIUM
 Add from day 3, can wait still serum k+ <4 in small
premature require – 2-3 mEq/kg/day
C. CALCIUM
Require in preterm , birth asphyxia and baby wt. < 1500gm
Add from day 1 – 36-72 mEq/kg/day or 4-8 ml/kg/day of 10%
cal. Gluconate
D. GLUCOSE REQIREMENT
Optimum requirement 4-6 mg/kg/min
Conc. Used – 5%, 10%, 12.5% (max)
Glucose infusion – (mg/kg/min) = % Gx rate(ml/hr)× 0.167 × wt.
Thumb rule – 3 ml/kg/hr of 10% D = 5mg/kg/min
Remain careful about glucose in – LBW, IDM, IUGR
Thank You

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Calculation of fluid

  • 2. TOTAL BODY WATER • 0.7 L/Kg in newborn • 0.6 L/Kg at 1 year age • ECF – 40% newborn 20% older children  Who required fluid ?  Infant <30 wks. & <1250 gm  Sick term neonates  Severe birth asphyxia  Apnea  RDS  Sepsis
  • 4. HOW MUCH FLUID TO BE GIVEN ? <1 kg 1-1.5 kg > 1.5 kg 1st day 100 mi/kg 80 ml/kg 60 ml/kg 7th day 190 ml/kg 170 ml/kg 150 ml/kg • Increase 15 ml/kg/day up to 6th day • Add 20 ml/kg/day for phototherapy & warmer • All calculation done on birth weight till body weight exceeds birth weight
  • 5. WHAT FLUID ? 1st 48 hrs. <1 kg 5% Dextrose 1-1.5 kg 10% Dextrose >1.5 kg 10% Dextrose After that ISO - P
  • 6. ELECTROLYTES REQUIRREMENT A. SODIUM  add – from day 2-3  In VLBW add when lost 6% weight  Require term and LBW 2-3 mEq/kg/day & ELBW 3-5 mEq/kg/day B. POTASIUM  Add from day 3, can wait still serum k+ <4 in small premature require – 2-3 mEq/kg/day
  • 7. C. CALCIUM Require in preterm , birth asphyxia and baby wt. < 1500gm Add from day 1 – 36-72 mEq/kg/day or 4-8 ml/kg/day of 10% cal. Gluconate D. GLUCOSE REQIREMENT Optimum requirement 4-6 mg/kg/min Conc. Used – 5%, 10%, 12.5% (max) Glucose infusion – (mg/kg/min) = % Gx rate(ml/hr)× 0.167 × wt. Thumb rule – 3 ml/kg/hr of 10% D = 5mg/kg/min Remain careful about glucose in – LBW, IDM, IUGR