Saturday, September 28, 2013

Calculations for Normal Maintenance of Intravenous Fluid Infusion

Hemodynamic Assessment: Continuum | Fluid Parameters in Shock | Treatment of Compensated Shock | Tourniquet Test

The following guidelines and tables are taken directly from a memo from the Department of Health, Philippines entitled "Revised Clinical Case Management Guidelines for Dengue 2011." The guidelines are not specific for Dengue cases and can be used for calculating maintenance fluids on all admitted patients. The addition of overweight and obese tables add to the quality of this guidelines.
Intravenous Fluid Therapy

IV Fluid Maintenance Computations

Normal maintenance fluid per hour can be calculated based on the following formula. Note: This is equivalent to the Holliday-Segar formula.

4 mL/kg/h for first 10 kg body weight
+ 2 mL/kg/h for next 10kg body weight
+ 1 mL/kg/h for subsequent body weight

*For overweight/obese patients, calcuate the normal maintenance fluid based on ideal body weight (IBW, see below). Adapted from the WHO, 1997.



IBW for Overweight/Obese Adults

Ideal Body Weight for overweight or obese adults  can be estimated based on the following formula.
Female: 45.5 kg + 0.91 (height - 152.4) cm
Male: 50.0 kg + 0.91 (height - 152.4) cm

From Gilbert DN, et al. 2007

Hourly Maintenance Fluid Regime for Overweight or Obese Patients 

For adults with IBW >50kg. 1.5 - 2ml/kg can be used for quick calculation of hourly maintenance fluid regime. For adults with IBW >50 kg, 2-3 ml/kg can be used for quick calculation of hourly maintenance regime.
Hourly Maintenance Fluid Regime for Overweight or Obese Patients
Click to Enlarge

Estimated Ideal Body Weight for Overweight or Obese Adults

Height (cm) | Estimated (IBW) for adult males

150 cm | 50 kg
160 cm | 57 kg
170 cm | 66 kg
180 cm | 75 kg

Height (cm) | Estimated (IBW) for adult females

150 cm | 45.5 kg
160 cm | 52 kg
170 cm | 61.5kg
180 cm | 70 kg




No comments:

Post a Comment