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Posted On : 22 Nov 2011

I work in a Level III NICU. We are looking for a reference as to what IV fluids to hang properatively for a neonate that is on full feeds of Similac 20. The electrolytes are normal. I belive that D5 1, 3NS is the best choice, but I don`t have a reference. My collegues want to hang D10W with NaCl and KCL. I think that makes the GIR too high intraoperatively and exacerbates the hyperglycemia associated with the stress response of the surgery.

Monica E. Ryan

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O

osama simsaa

0

the best iv fluid to neonate is D10 percent,unless,there is renal failure ,pre term wt less than 1 kg .At same time you should give k Ca and Na ,as maintainace after age of 2days and pt passing urine

13 years ago

S

Shatha Ali

0

D5 , 1, 3 NS

13 years ago

M

mahmoud alkeshki

0

we use D5,3NS

13 years ago

S

sarah Ashour

0

1, 2 D, S

13 years ago

Answer 1

Dear Monica Ryan

This debate has been raging all over the world for some decades. Each NICU has their own policies. Indeed, we worked through 1980s through units doing Urea, Electrolytes EVERYDAY and adjusting fluids accordingly. Now most people agree that there is some sodium retention following surgery. Also ADDING NaCl and KCL externally has its own disadvantages of contamination - calculation errors etc. I would personally stick to `ready made fluids` like D51............................Dr Neena Modi has written an excellent article about Na haemostasis in Archives few years ago....it is worth reading. Trust this helps.

Regards
Kishore
Prof. R. Kishore Kumar
MBBS, DCH {Mys}, MD {Paed - Gold Medalist}, DCH {Lond}, MRCP {Paed}, FRCPCH {UK}, FRCPI, FRACP {Australia}

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