What tonicity of intravenous maintenance fluids should I prescribe to postoperative patients?

[摘要] You are consulted to co-manage a 6 year old girl being admitted for an elective complex orthopedic procedure who is expected to be hospitalized for 72 hours. In addition to managing any problems related to her mild persistent asthma, you are asked to prescribe postoperative intravenous fluids. During rounds, your medical student confidently recommends D5 with 0.2% NS to run at 60 cc/hour in this 20kg child based on the Holliday-Segar method which she is very proud to have mastered. Mastery of simple math asid, is she correct to choose this fluid? IVF are one of the most familiar tools in the pediatric hospitalist’s tool box, and often our first experience in the hospital was learning to compute maintenance IVF. In the “old” days, after any deficit was replaced, 0.2% NS was prescribed for maintenance as calculated by Holliday and Segar 55 years ago1. Over time the recognition of nonosmotic stimuli for ADH production, and iatrogenic hyponatremia, occasionally accompanied by severe neurologic morbidity and death, has put into question the use of hypotonic maintenance fluids 2, 3. …

[学科分类] 儿科学

[关键词] Campylobacter;proljev;dob