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26 lis 2023 · In anesthetic practice, this formula has been further simplified, with the hourly requirement referred to as the “4-2-1 rule” (4 mL/kg/hr for the first 10 kg of weight, 2 mL/kg/hr for the next 10 kg, and 1 mL/kg/hr for each kilogram thereafter.
5 lip 2023 · Maintenance IV fluids are appropriate for euvolemic patients who cannot take adequate enteral fluids; Calculate hourly maintenance fluid rates using standard weight-based formula (4-2-1 rule) Do not use maintenance IV fluids at rates above calculated maintenance, and calculate replacement for ongoing fluid losses separately from maintenance
The 4 – 2 – 1 rule for maintenance IV fluid therapy (Normal Saline or Ringer’s Lactate): 4 ml/kg/hr for the first 10kg of body mass. 2 mg/kg/hr for the next 10 kg of body mass. 1 mg/kg/hr for body mass beyond 20kg. Reduce the rate by 40% in normovolemic children to prevent fluid overload.
25 wrz 2023 · Instead of the 4-2-1 rule, healthy children presenting with marginal to moderate hypovolemia (e.g., fasting for surgery) should be administered 20-40 mL/kg of isotonic fluids during the surgery and postanesthesia care unit.
2 wrz 2021 · NICE guidelines recommend restriction of fluids by 50 to 80% because of non-osmotic ADH secretion. The current guidelines recommend giving balanced solutions with 1-2.5% Dextrose to start with and then adjust the infusion according to clinical parameters.
19 kwi 2023 · If parenteral fluid management is necessary, isotonic solutions should be used as maintenance fluids in children, and the rate should be half of the “4-2-1” rule (i.e., the “2-1-0.5” rule) when hourly urine volume is diminished due to ADH secretion.
Delivering a particular quantity of water, dextrose, and electrolytes every hour at a weight-based “maintenance rate” is intended to meet the cellular requirements for basic functionality. The widely used formula for calculating this rate (the “4-2-1 rule”) was developed in 1957 and was popularized as much for simplicity as for accuracy.
