![]() Normal physiologic needs - Homeostatic control for water depends on antidiuretic hormone (ADH) release, the kidney's ability to regulate urinary water losses via its response to ADH, and water intake based on thirst (see "General principles of disorders of water balance (hyponatremia and hypernatremia) and sodium balance (hypovolemia and edema)", section on 'Regulation of water and sodium balance'). Anions – Usually chloride occasionally bicarbonate, acetate, and lactate.Cations – Typically sodium and potassium.These data form the basis of IV maintenance fluid therapy in children that has undergone modifications based on clinical experience and observation and encompass these components: Historically, water and electrolyte requirements were initially directly derived from the caloric energy expenditures of hospitalized, normally healthy children on bed rest who were receiving intravenous (IV) fluids. (See "Clinical assessment of hypovolemia (dehydration) in children" and "Treatment of hypovolemia (dehydration) in children in resource-rich settings" and "Fluid and electrolyte therapy in newborns".)ĬOMPONENTS OF MAINTENANCE FLUID THERAPY - Maintenance therapy replaces the ongoing daily losses of water and electrolytes occurring via physiologic processes (urine, sweat, respiration, and stool), which normally preserve homeostasis. Assessment of hypovolemia and repletion therapy and management of fluid and electrolytes in neonates are discussed elsewhere. Maintenance intravenous (IV) fluid therapy, including alterations in maintenance requirements, will be reviewed here. Repletion returns the patient to a normal volume and electrolyte status. ![]() Repletion fluid therapy corrects water and acute electrolyte deficits that have accrued via illness or physiologic abnormality.Maintenance requirements vary depending on the patient's underlying clinical status and setting, especially in postoperative or hospitalized children, due to changes in their physiologic responses (eg, excess antidiuretic hormone secretion). Maintenance fluid therapy replaces the ongoing daily losses of water and electrolytes occurring via physiologic processes (urine, sweat, respiration, and stool), which normally preserve homeostasis.INTRODUCTION - The goal of fluid therapy is to preserve the normal body water volume and its electrolyte composition: ![]()
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