Fluid Treatment Patterns

(Diarrhea)
Victor S. Doctor, M.D.
FPPS, FPNSP, FPSN

0
A. Mild Dehydration
I. Rehydration 3-10 kg Infant
I. Rehydration Child > 10 kg
How much 3-10 kg Infant
Wt. x 50 cc/kg Wt. x 30 cc/kg
Child > 10 kg
How long 4-8 hours 4-8 hours
How much
What solution D5 0.3% NaCl
Wt. x 50 cc/kg D5 0.3% NaCl
(D5 0.3% NaCl)
Wt. x 30 cc/kg
How long (Na – Cl)
4-8 hours (51 – 51)
4-8 hours
II. Maintenance What solution
3-10 kg Infant Child > 10 kg
D5 0.3% NaCl
How much Wt. x 100 cc/kg Wt. x 75 cc/kg
(D5 0.3% NaCl)
How long (Na – Cl) 16-24 hrs 16-24 hrs
What solution (51 – 51) D5 IMB D5 NM
D5 0.3% NaCl
(Na – K – Cl) (Na – K – Cl)
(25 – 20 – 22) (40 – 13 – 40)

1
B. Moderate Dehydration
I. Resuscitation 3-10 kg Infant Child > 10 kg
How much 20 cc/ kg 20 cc/ kg
How long 20 minutes 20 minutes
What solution Plain LRS or NSS Plain LRS or NSS

II. Rehydration 3-10 kg Infant Child > 10 kg

How much Wt. x 100 cc/kg Wt. x 60 cc/kg
How long 4–8 hrs 4–8 hrs
What solution D5 0.3% NaCl D5 0.3% NaCl
(D5 0.45% NaCl) (D5 0.45% NaCl)

III. Maintenance 3-10 kg Infant Child > 10 kg

How much Wt. x 100 cc/kg Wt. x 75 cc/kg
How long 16–24 hrs 16–24 hrs
What solution D5 IMB (Na–K–Cl) D5 NM (Na–K–Cl)
(25–20–22) (40–13–40) 2
C. Severe Dehydration
I. Resuscitation 3-10 kg Infant Child > 10 kg
How much 20 cc/ kg 20 cc/ kg
How long 20 minutes 20 minutes
What solution Plain LRS or NSS Plain LRS or NSS

II. Rehydration 3-10 kg Infant Child > 10 kg

How much Wt. x 150 cc/kg Wt. x 90 cc/kg
How long 4–8 hrs 4–8 hrs
What solution D5 0.3% NaCl D5 0.3% NaCl
(D5 0.45% NaCl) (D5 0.45% NaCl)

III. Maintenance 3-10 kg Infant Child > 10 kg

How much Wt. x 100 cc/kg Wt. x 75 cc/kg
How long 16–24 hrs 16–24 hrs
What solution D5 IMB (Na–K–Cl) D5 NM (Na–K–Cl)
(25–20–22) (40–13–40) 3
IV Solutions to be used in Diarrhea
Treatment Stages Solutions Na–K–Cl
1. Resuscitation Plain LRS 13–4-109
Plain NSS 150-0-154
2. Hydration D5 0.3% NaCl 51–0–51
D5 0.45% NaCl 77–0–77
ORESOL 75–20–65
3. Maintenance D5 IMB 25–20–22
D5 NM 40–13–40
ORESOL 75–20–65

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Dengue (Model for All Pediatric Ages)
II. Maintenance Solutions
A. Mild Dehydration
How much As tolerated
How long All day
I. Rehydration Solutions
What solution ORESOL with food
How much As tolerated
How long Daily unless patient worsens
What solution ORESOL with food

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B. High Risk – Moderate to Severe Dehydration
I. Resuscitate (Shock)
How much 20 cc/kg
How long 20 minutes
What solution Plain LRS or Plain NSS

II. Rehydration
Severe 2 hrs How much 7–11 cc/kg
Dehydration How long 1–2 hrs
What solution D5 LRS or D5 NSS
Moderate 3 hrs How much 5–7 cc/kg
Dehydration How long 2–4 hrs
What solution D5 LRS or D5 NSS
Mild Dehydration 3 hrs How much 3–5 cc/kg
How long 2–4 hrs
What solution D5 LRS or D5 NSS
Total 8 hrs

III. Maintenance
How much 2–3 cc/kg
How long Continuous 16–24 hrs
What solution D5 LRS 6
(ORESOL or food)
 Summary of Numbers
Diarrhea
Treatment Stages Dengue Duration
Infant Child

1. Resuscitation 20 cc/kg 20 cc/kg 20 cc/kg 20 mins.

2. Severe Dehydration 150 cc/kg 90 cc/kg 11 cc/kg 2 hrs

(11 x 8 hrs = 88*) (1–2 hrs)
3. Moderate Dehydration 100 cc/kg 60 cc/kg 7 cc/kg 3 hrs
(7 x 8 hrs = 56*) (2–4 hrs)
4. Mild Dehydration 50 cc/kg 30 cc/kg 5 cc/kg 3 hrs
(5 x 8 hrs = 40*) (2–4 hrs)
Total 8 hrs 8 hrs (* x 8 hrs) 8 hrs

5. Maintenance 100 cc/kg 75 cc/kg 3 cc/kg (72) 16 hrs

Total 16 hrs 16 hrs ––––––––––> 16 hrs

Grand Total 24 hrs 24 hrs 24 hrs

* 88, 56, and 40 are values near 90, 60, and 30 for diarrheas