Maintenance fluids

April 06, 2022

In this episode, listeners will learn about the intricacies of how the AAP guidelines came to be on maintenance intravenous fluids for pediatric patients. Get ready to learn about the 4-2-1 rule and breakdown some misconceptions about fluids based on adult data! 


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This episode was written by Dr. Tammy Yau and Dr. Lidia Park with content support from Dr. Alexis Toney, Dr. Lena van der List, and Dr. Su-Ting Li. Drs. Tammy and Lidia take full responsibility for any errors or misinformation. 

Key points: 

-Remember the 4-2-1 rule for calculating maintenance fluids in children 

-Use of hypotonic fluids is based on historical data in healthy children 

-Data now supports use of isotonic fluids like NS or LR to reduce risk of hyponatremia and SIADH 

-Newer data may support LR over NS 


Supplemental information 

AAP 2018 Maintenance Fluid Guidelines: