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Maintenance fluid therapy in children

Michael J Somers, MD
Section Editor
Tej K Mattoo, MD, DCH, FRCP
Deputy Editor
Melanie S Kim, MD


The goal of fluid therapy is to preserve the normal volume and electrolyte composition of body fluids. Fluid therapy is usually divided into two components:

Maintenance therapy replaces the ongoing daily losses of water and electrolytes occurring via physiologic processes (urine, sweat, respiration, and stool), which normally preserve homeostasis. 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 [ADH] secretion).

Repletion therapy corrects water and acute electrolyte deficits that have accrued via illness or physiologic abnormality. Repletion returns the patient to a normal volume and electrolyte status.

Maintenance fluid therapy, including alterations in maintenance requirements, will be reviewed here. Assessment of hypovolemia and repletion therapy are discussed elsewhere. (See "Clinical assessment and diagnosis of hypovolemia (dehydration) in children" and "Treatment of hypovolemia (dehydration) in children".)



Normal physiologic needs — Homeostatic control for water is dependent on antidiuretic hormone (ADH) release, the kidney's ability to regulate urinary water losses, 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'). These regulatory mechanisms allow for variability in the daily water intake in healthy children without adverse effect.

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Literature review current through: Nov 2017. | This topic last updated: Jan 26, 2016.
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