maintenance fluids in children

Last reviewed 01/2018

The child with a major burn is particularly prone to fluid loss after burn injury. This is because, compared to an adult, there is a relatively greater surface area to volume ratio and more limited physiological compensation.

Hence, in addition to replacement of fluid losses according to the Parkland Formula, children need maintenance fluids. The volume to administer every 24 hours is calculated from the following:

• 100 mls per kg up to 10 kg body weight, and in addition
• 50 mls per kg from 10 kg to 20 kg, and in addition
• 20 mls per kg for every kg over 20 kg

Hence, a 25 kg child would require 1600 mls of maintenance fluid every 24 hours.

The type of fluid is dextrose saline. However, as hyponatraemia is more likely in a child, if delay occurs before resuscitation, a relatively greater concentration of saline is required.

If vomiting occurs, replacement should be with a similar estimated volume of a fluid of similar physiological composition, for example dextrose saline with potassium.