Anaes SAQs · Paediatric anaesthesia
Paediatric fluids, fasting, and glucose: Holliday-Segar and safe maintenance
Final-examination SAQ for paediatric-fluids-fasting-glucose.
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Prompt
Calculate maintenance fluids for a 22 kg child, justify fluid type, state fasting guidance for clears versus solids, and discuss hyponatraemia prevention.
Model answer
Calculation (4). 4-2-1: 40+20+2=62 mL/h.[1]
Fluid type (4). Isotonic maintenance with appropriate potassium chloride and dextrose for children 28 days to 18 years in scope populations; avoid hypotonic default, per local paediatric-fluid protocol.[2]
Fasting (4). Solids ~6 h and breast ~4 h are classic teaching per local policy; clears 1–2 h — ASA/ESAIC minimum 2 h with several societies endorsing 1 h.[3]
Hyponatraemia (3). Postoperative ADH impairs free-water excretion; isotonic fluids significantly decrease hyponatraemia risk; monitor sodium, as the cited fluid-type teaching above states.[2]
References3ShowHide
- [1]Holliday MA, Segar WE The maintenance need for water in parenteral fluid therapy. Pediatrics, 1957.PMID 13431307
- [2]Feld LG, Neuspiel DR, Foster BA, et al. Clinical Practice Guideline: Maintenance Intravenous Fluids in Children. Pediatrics, 2018.PMID 30478247
- [3]Disma N, Frykholm P, Cook-Sather SD, et al. Pro-Con Debate: 1- vs 2-Hour Fast for Clear Liquids Before Anesthesia in Children. Anesth Analg, 2021.PMID 34403386