Intravenous fluid calculation for neonates.

Posted on: Friday, November 2nd, 2018 @ 1:24 PM - By: Mohemet - Seen 162 Times

Intravenous fluid calculation for neonates is different than older infants because they have more body surface area in relation to their weight, so they lose more water through skin and hence they need more fluid replacement.

**IV fluid requirement in term neonates

Day 1:  60 ml/kg GW 10%

Day 2:  80 ml/kg GW 10%

Day 3:  100 ml/kg Glucose/Saline 1/5

Day 4:  120 ml/kg Glucose/Saline 1/5

Day 5:  140 ml/kg Glucose/Saline 1/5

Day 6:  150 ml/kg Glucose/Saline 1/5

Days 7-28: 150 ml/kg Glucose/Saline 1/5

Notice: Sodium should be added to fluid after 48 hours of age, so type of fluid after this age period will be Glucose saline 1/5, if there is risk of hypoglycemia the glucose percent will be increased from 5% to 10%, so the fluid will be (Glucose10%/saline 1/5).

How to prepare 10%Glucose in G/S 1/5: G/S 1/5 contains 4gm glucose per 100ml, so we need to add extra 6gm/100ml of glucose. This is done by using Hypertonic GW 50% which contains 0.5gm/1ml, to add 6gm we need 12 ml of hypertonic GW50% to add for each 100ml fluid (for 500ml fluid we should add 5*12=60ml of Hypertonic GW50%).

**IV fluid requirement in preterm neonates:

Day 1:  80 ml/kg GW 10%

Day 2:  100 ml/kg GW 10%

Day 3:  120 ml/kg Glucose 5-10%/Saline 1/5

Day 4:  140 ml/kg Glucose 5-10%/Saline 1/5

Day 5:  160 ml/kg Glucose 5-10%/Saline 1/5

Day 6:  180 ml/kg Glucose 5-10%/Saline 1/5

Days 7-28: 180 ml/kg Glucose 5-10%/Saline 1/5

Notice: for preterm infants, it’s better to give 10% Glucose in 1/5 G/S instead of Glucose/Saline 1/5 as they are more prone to develop hypoglycemia. See above to know how to prepare 10%Glucose/Saline 1/5. For preterm neonates who are ELBW wt<1kg or their GA < 28, more fluid should be given from day one. 100-150ml/kg will be given.

Warning: Holiday-Segar method of calculating fluid for infants and older children is not applicable for neonates, neither for term nor preterm neonates. It’s applied after 28 days of life.

To know how to calculate IV fluid for infants and older children, click here

Filed under: Featured / Neonatology