# Pediatric Urology Database

Pediatric Urology Database

Jeffrey A. Stock

I. INTRAVENOUS FLUID THERAPY

A. Maintenance of Normal Kidney Function

1. Fluid requirements

a. Method to estimate daily maintenance rate of fluid

(1) First 10 kg body weight: 100 mL/kg per day

(2) Second 10 kg body weight: 50 mL/kg per day

(3) Third 10 kg body weight and beyond: 25 mL/kg per day

(4) Example 1: A 3-kg infant requires 300 mL fluid per day

(5) Example 2: A 13-kg child requires 1,150 mL fluid per day (1000 + 150 mL)

(6) Example 3: A 40-kg adolescent requires 2,000 mL fluid per day (1,000 + 500 + 500 mL)

b. Method to estimate hourly maintenance rate of fluid

(1) First 10 kg body weight: 4 mL/kg per hour

(2) Second 10 kg body weight: 2 mL/kg per hour

(3) Third 10 kg body weight and beyond: 1 mL/kg per hour

(4) Example 1: A 3-kg infant requires 12 mL per hour (3 kg × 4 mL/kg/h = 12 mL/h)

(5) Example 2: A 13-kg child requires 46 mL per hour [(10 kg × 4 mL/kg/h) + (3 kg × 2 mL/kg/h) = 46 mL/h]

(6) Example 3: A 40-kg adolescent requires 80 mL per hour: [(10 kg × 4 mL/kg/h) + (10 kg × 2 mL/kg/h) + (20 kg × 1 mL/kg/h) = 80 mL/h)]

2. Electrolyte requirements

a. Na+: 50 mEq/m2 per day or 3 to 4 mEq/kg per day

b. K+: 20 mEq/m2 per day or 2 mEq/kg per day

3. Appropriate solution: The most appropriate solution for routine fluid therapy in postoperative patients is Lactated Ringers (LR).

4. Losses: Losses (e.g., nasogastric suction) must be replaced accurately. Children are best followed up for dehydration by monitoring urine output. If the urine output is between 1 and 2 mL/kg per hour, the appropriate amount of fluid is probably being given.

II. PEDIATRIC UROLOGY FORMULARY

The information provided is not comprehensive. Please consult a more complete reference before using medications with which you are unfamiliar. (Please note that in the “Supplied As” category, the unit quantity in which a drug is supplied is noted in parentheses after the drug concentration; Table 33-1.)

TABLE 33-1 Pediatric Dosages