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Maintenance Fluids Calculations

Calculators  Gastrointestinal
Maintenance fluids calculations is a calculating method for patients who are not able to take oral fluids. this tool is used to determine the IV fluid in pediateric patients.


Measured Factor
IV fluid rates
Measured Factor Disease
  • Electrolyte loss
Measured Factor Detail
IV fluid rates is determine to check the loss of electrolyte in the patients according to their weight by using 4-2-1 rule.
Allied Health Professional
Body System
4/2/1 Rule

Result Interpretation

Ranges Ranges
  • Critical High: >20 kg
  • Normal: 0
  • Normal Pediatric: 0
Result High Conditions
  • With increase in the body weight of patient there is a need of more of IV fluids for maintainance of electrolytes in the body.
Test Limitations
Maintenance Fluids Calculations basically calculates maintenance fluid requirements based only on weight but it differs for some chronic illnesses, such as renal disease, metabolic disease, and diabetes.
References: 2


Study Validation 1
The randomized controlled trials were conducted on 3,861 patients to identify the liberal use of perioperative fluid therapy without haemodynamic goals had different effects to goal-directed fluid therapy. Patients in the goal-directed (GD) groups had a significantly shorter hospital stay, renal complications and less frequent pneumonia in comparison to non-goal-directed groups. Patients in liberal fluid groups had a longer hospital stay, pulmonary oedema and more frequently reported pneumonia in comparison to restrictive fluid groups. The results of the study demonstrated that perioperative outcomes preferred a GD therapy rather than liberal fluid therapy without hemodynamic goals.
References: 3
Study Validation 2
A non-consecutive cohort study was conducted on children ≤ 18 years of age with vomiting or diarrhoea, to verify three popular clinical dehydration scales and overall physician gestalt relative to the criterion standard of per cent weight change with rehydration. Receiver operating characteristics (ROC) curves were designed to calculate sensitivity and specificity. The area under the ROC curve (AUC) for both the Gorelick scales and the Clinical Dehydration Scale (CDS) was statistically different from the reference line with AUCs of  0.71 (95% CI 0.57, 0.85) and 0.72 (95% CI 0.60, 0.84) respectively. The physician gestalt and the World Health Organization (WHO) scale had AUCs of  0.61 (0.44, 0.78) and 0.61 (95% CI 0.45, 0.77), and that was not statistically significant. The outcomes of the study depicted that the Clinical Dehydration Scale and the Gorelick scale were found to be fair predictors of dehydration in children with vomiting or diarrhoea.
References: 4
Study Additional 1
The aim of the study was to manage the perioperative fluid, blood transfusion, and electrolyte therapy in paediatric surgical patients. Generally, the total body water of a newborn is approximately 75-80% and reduces gradually as muscle and fat content rises with age to the adult level of approximately 60%. Newborns with a higher total water content, large surface-to-weight ratio, limited renal ability to concentrate, high blood flow, and greater insensible water loss from thin skin all can become clinically dehydrated in a very brief period of time. The outcomes of the study showed that meticulous fluid management is required in paediatric patients due to extremely limited margin for error.
References: 5
Study Additional 2
The aim of the study was to facilitate the granting of a European marketing authorisation for improving the effectiveness and safety of intraoperative fluid therapy in children. In order to avoid hyponatraemia, an intraoperative fluid should have an osmolarity close to the physiologic range in children, to prevent hyperchloraemic acidosis, they should also include metabolic anions as bicarbonate precursors, and in order to avoid lipolysis, hyperglycaemia or hypoglycaemia, an addition of 1-2.5% instead of 5% glucose was recommended.
References: 6


  1. Arya VK. Basics of fluid and blood transfusion therapy in paediatric surgical patients. Indian J Anaesth. 2012;56(5):454-62.
  2. Conn RL, Mcvea S, Carrington A, Dornan T. Intravenous fluid prescribing errors in children: Mixed methods analysis of critical incidents. PLoS ONE. 2017;12(10):e0186210.
  3. Corcoran T, Rhodes JE, Clarke S, Myles PS, Ho KM. Perioperative fluid management strategies in major surgery: a stratified meta-analysis. Anesth Analg. 2012;114(3):640-51.
  4. Jauregui J, Nelson D, Choo E, et al. External validation and comparison of three pediatric clinical dehydration scales. PLoS ONE. 2014;9(5):
  5. Arya VK. Basics of fluid and blood transfusion therapy in paediatric surgical patients. Indian J Anaesth. 2012;56(5):454-62.
  6. Sümpelmann R, Becke K, Crean P, Jöhr M, Lönnqvist PA, Strauss JM, et al. European consensus statement for intraoperative fluid therapy in children. Eur J Anaesthesiol. 2011;28(9):637-9.

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