Intravenous Fluid Guidance in Previously Well Children Aged 7 Days to 16 Years (172)

What's new / Latest updates

21/02/2025 Strengthened recommendation to reduce fluids to 70% maintenance in many patients

Increased frequency of body weight estimation as part of fluid balance estimation

Objectives

This guideline is for use by paediatric medical staff during the administration of MAINTENANCE IV fluid therapy in previously well children aged >7 days to 16 years (separate guidelines available for DKA, burns and NICU). If the patient may have renal impairment, IV fluids must be discussed with the renal team.

Algorithm

IV fluid constituents

	Plasma	Plasmalyte	Hartmanns	0.9% NaCI	0.18% NaCI 10% Dex	0.45% NaCI 5% Dex
Na⁺mmol/l	135-145	140	131	154	31	77
K⁺mmol/l	3.5-5.3	5	5	-	-	-
CL^-mmol/l	95-105	98	111	154	31	77
HCO₃^-,mmol/l	24-32	27(acetate)	29(Lactate)	-	-	-
Glucose g/l		-	-	-	100	50
Glucose, mmol/l	4-8	-	-	-	556	278
Mg⁺⁺mmol/l	0.8-1.2	1.5	0	0	0	0
Ca⁺⁺mmol	2.2-2.6	-	2	-	-	-
Osmolarity, m0sm/l	280-310	294	277	308	284	406
pH	7.35-7.45	7.4	6.5	5		4.4

RHC Neonatal IV Fluid Therapy Guideline

This guideline is for use by medical and nursing staff during administration of MAINTENANCE IV fluid therapy in unventilated, stable neonates >35 weeks gestation who are aged < 7 days old and are inpatients of RHC (not NICU or PICU). If in PICU use this guideline Prescribing and Preparing Intravenous Fluids in PICU | NHSGGC

The standard maintenance fluid to prescribe for these patients is: Plasmalyte & 10% Dextrose (see supplemental monograph on how to prepare this)

Monograph: Making alterations to Plasmalyte IV maintenance bags

RHC Paediatric Intensive Care Unit: Making alterations to Plasmalyte IV maintenance bags

Last reviewed: 17/11/2025

Next review date: 28/02/2028

Author(s): Graham Bell.

Version: 6

Author email(s): Graham.bell6@nhs.scot.

Approved By: Paediatric Guidelines Group

Document Id: 172

Intravenous Fluid Guidance in Previously Well Children Aged 7 Days to 16 Years (172)

Objectives

Algorithm

IV fluid constituents

RHC Neonatal IV Fluid Therapy Guideline

Editorial Information