Accepted
at 10:39 p.m. Jun, 24, 2026
by
braviboron
Author:
kyle.robinson
Type of change:
Updated content
Rationale for change
I believe historically the 0.18% NaCl + 4% glucose was the go to maintenance in ADULTS. Now, 0.3% NaCl + 3.3% dextrose with K+ is recommended (see guideline already in sources).
Why?
The first preparation is in practice extremely hypotonic, the glucose is rapidly taken up and metabolised by cells leaving only the 0.18% NaCl (almost free water). This is particularly problematic in unwell children who have higher levels of ADH release. It resulted in a number of deaths due to innapropriate use within that population.
The newer preparation doesn't actually fix this issue but changes it from being a severely hypotonic solution to a moderately hypotonic solution. As such it is still not indicated in unwell children.
Before
After
Extra
Extra
Extra
Extra
Text
What are the daily sodium, potassium, and chloride requirements in maintenance fluid therapy?
{{c1::Approximately 1 mmol/kg/day of each}}
{{c1::Approximately 1 mmol/kg/day of each}}
Extra (Synced)
Empty field
Personal Notes
Empty field
Missed Questions
Empty field
eTG Complete
Empty field
Talley & O'Connor
Empty field
Additional Resources
Empty field
Additional Resources (Synced)
Empty field
Source
Prescribing IV Fluids Guidelines Adult - Queensland Health. Accessed June 2026.
One by one
Empty field