This document discusses maintenance fluid requirements and calculations for various medical conditions. It provides examples of conditions that cause increased or decreased fluid intake and output. It then gives guidelines for calculating daily maintenance fluid needs based on medical conditions like infections, heart failure, and sickle cell disease. The document also provides specifics on maintenance fluid types and amounts for pediatrics, neonates, and malnourished patients. References for the guidelines are also listed.

1. LECTURER : DR JOAN
PRESENTER: BYAMUKAMA ALEX

2. MAINTENANCE FLUID
Sick patient with
Reduce intake
Increase output

3. MECHANISM EXAMPLES
 Gastrointestinal loss : Excessive vomiting and diarrhoea ,Nasogastric drainage,
Fistula drainage
 Haemorrhage : Internal or external Fluid sequestration , Paralytic ileus,
intestinal obstruction y Peritonitis
 Loss through skin/wounds : Sweating , Extensive burns
 Urinary loss : Decompensated diabetes
 Fluid retention and electrolytes or water imbalances : Renal, hepatic and heart
failure
 Reduced intake :Post operative patients Excessive intake y Water intoxication, IV
fluids overload

4. Daily necessities: 1500ml – 2000/m2BSA/24hrs

5. How to calculate
Severe bacterial infection: 1500 - 2000ml/m2/24hrs
Heart failure: 800ml/m2/24hrs
Respiratory diseases: 1000ml/m2/24hrs
Nervous infection: 1000ml/m2/24hrs
Vaso-occlusive crises of sickle cell disease:
2000ml/m2 /24hrs
Poisoning: 2000ml/m2 /24hrs

6. Type of maintenance fluids in Paediatrics
patients
5% Dext or 10% Dext (in mal nutrition patients)
½ part
Normal Saline solution ½ part + 5% Dextrose ½
part
K: 40 meq/m2/24hrs (amps 25.5meq-10ml)
Drip or dripping: Total of
fluids/#Hrsx3(constant)

7. Type of maintenance fluids in neonates
Day Dose
1 60ml/kg/day
2 90ml/kg/day
3 120ml/kg/day
4 150ml/kg/day
5 and
more
150ml/kg/day

8. Type of maintenance fluids in neonates
10% Dext
Na: 3meq/kg/day after 48 hrs (amps 34meq-
10ml) and (75.5meq-20ml)
K: 3 meq/kg/day after 72 hrs (25.6meq-10ml)
Ca: 200mg/kg/day after 24 hrs (amp 100mg-iml)
Mg: 50mg/kg/day after 24 hrs (amp 1g-10ml)

9. PLAN A
50-100ml/ motion infant-2years
100-120ml/ motion 3 years- 5 years
120-200ml/motion 6 years- 10 years
Free, above 10 years

10. Plan B
75-100ML/Kg/ 6 or 4 hours

11. Malnourished
Do not use IV route for rehydration, except in cases of
shock
Rehydrate slowly, either orally or by NGT using ReSoMal, a
specially prepared rehydration solution for malnutrition,
the standard ORS has a high sodium and low potassium
content, which is not suitable for SAM, except if profuse
diarrhoea is present
 .

12. ReSoMAL
Give 5ml/kg every 30 minutes for the first 2
hours
Then give 5-10 ml/kg per hour for the next
4-10 hours, with F-75 formula. Exact
amount depends on how much the child
wants, the volume of stool loss and whether
the child is vomiting

13. REFERENCES
UGANDA CLINICAL GUIDELINES2020
IMAM 2020
NATIONAL GUIDELINES FOR MANAGEMENT OF COMMON
CONDITIONS

14. END
 THANKS FOR ATTENDING , LISTENING AND PARTICIPATING
WELCOME TO THE WORLD OF
DISCOVERY