Fluid Administration

Fluid and Glucose Requirements

Reviewed by Carl Kuschel and David Knight
January 2007
Clinical Guidelines Back Newborn Services Home Page
Recommended Volumes Insensible Water Loss Glucose Intake Gastrointestinal Losses
Chest and Peritoneal Drains Renal Impairment Glucose Solutions References

Recommended Volumes (ml/kg/day)

  Day 0-1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7+
<37 weeks 60 75 90 105 120 150 180
37 weeks+ 60 75 90 105 120 120 150
Note:
  • Fluid volumes administered in NICU after the first week are high to ensure good caloric intake and growth in preterm infants.
    • Term infants have a lower requirement for fluids and calories.
  • Infants admitted to Starship Hospital (surgical or medical services) should have fluids prescribed according to Starship Hospital guidelines (available via the intranet).
 
  • The volume administered will depend on the clinical condition of the infant, with fluid restriction indicated with asphyxia, renal impairment or PDA.
  • Infants receiving phototherapy, or with high insensible losses, may require higher fluid intakes.
  • In general, fluid management in the first few days is adjusted primarily on serum sodium values and changes in weight.
    • High serum sodium values usually indicate that the infant requires more fluid.
    • Low serum sodium values may indicate that the infant requires less fluid, or that the infant has high sodium losses.
 

Glucose Intake

Glucose intake (mg/kg/min) =

% Dextrose x Volume (ml/kg/day)
144

or

   

Glucose intake (mg/kg/min) =

% Dextrose x Hourly Rate
Weight (Kg) x 6

 
Intake
(ml/kg/day)

5% Dextrose

10% Dextrose

12.5% Dextrose

mg/kg/min of Dextrose

60

2.1

4.2

5.2

75 2.6

5.2

6.5

90

3.1

6.3

7.8

105 3.7 7.3 9.1

120

4.2

8.3

10.4

150

5.2

10.4

13.0

180

6.3

12.5

15.6

To get concentrated glucose solutions:     See also the Fluid and Electrolytes calculator

Solution 10% Dextrose 50% Dextrose
12.5% 450 ml 30 ml
15 % 420 ml 60 ml
20 % 400 ml 135 ml
Solution 5% Dextrose 50% Dextrose
7.5% 450ml 30ml

Insensible Water Loss

Gastrointestinal Losses

Chest and/or Peritoneal Drains

Renal Impairment

FE Na+ =

 Urine [Na] x Serum Creatinine
Serum [Na+] x Urine Creatinine

x 100%

References

1

Bell EF, Acarregui MJ. Restricted versus liberal water intake for preventing morbidity and mortality in preterm infants. Cochrane Database of Systematic Reviews 2001, Issue 3. Art. No.: CD000503. DOI: 10.1002/14651858.CD000503.

2

Hartnoll G, Betremieux P, Modi N. Randomised controlled trial of postnatal sodium supplementation on oxygen dependency and body weight in 25-30 week gestational age infants. Arch Dis Child Fetal Neonatal Ed 2000;82(1):F19-23.

3

Hartnoll G, Betremieux P, Modi N. Randomised controlled trial of postnatal sodium supplementation on body composition in 25 to 30 week gestational age infants.  Arch Dis Child Fetal Neonatal Ed 2000;82(1):F24-8.

4

Hartnoll G, Betremieux P, Modi N. Randomised controlled trial of postnatal sodium supplementation in infants of 25-30 weeks gestational age: effects on cardiopulmonary adaptation. Arch Dis Child Fetal Neonatal E. 2001;85(1):F29-32.

5

Costarino AT Jr, Gruskay JA, Corcoran L, Polin RA, Baumgart S. Sodium restriction versus daily maintenance replacement in very low birth weight premature neonates: a randomized, blind therapeutic trial.  J Pediatr 1992;120(1):99-106.

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