The Cribsiders

S4: Bonus! Maintenance Fluids Extra

Feb 17, 2023
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ADVICE

Sodium in Maintenance Fluids

  • Consider hypotonic fluids like half-normal saline for maintenance to avoid hypernatremia.
  • However, be aware of potential hyponatremia risks, especially in patients with elevated ADH levels.
INSIGHT

Maintenance Fluid Guidelines

  • American Academy of Pediatrics guidelines recommend normal saline for patients aged one month to 18 years for ongoing maintenance therapy to avoid hyponatremia.
  • Individualized approaches based on patient risk for dysnatremia are also valid, with follow-up and adjustments based on labs.
INSIGHT

ADH and Hyponatremia

  • ADH, a fight-or-flight response, increases water reabsorption.
  • In critically ill patients or those with certain conditions, ADH can contribute to hyponatremia, especially with incorrect fluid choices.
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