TY  - CHAP
M1  - Book, Section
TI  - Maintenance Fluids
A1  - Rozenfeld, Ranna A.
PY  - 2018
T2  - The PICU Handbook
AB  - Parenteral  fluids  are  typically  administered  to  patients  whose  spontaneous  and/or  enteral  intake  is  insufficient  to  meet  physiologic  needs.  Delivering  a  particular  quantity  of  water,  dextrose,  and  electrolytes  every  hour  at  a  weight-based  “maintenance  rate”  is  intended  to  meet  the  cellular  requirements  for  basic  functionality.  The  widely  used  formula  for  calculating  this  rate  (the  “4-2-1  rule”)  was  developed  in  1957  and  was  popularized  as  much  for  simplicity  as  for  accuracy.  Its  original  proponents  utilized  a  rough  estimate  of  patient  energy  requirements  to  extrapolate  fluid  needs,  escalating  stepwise  with  increases  in  weight,  to  arrive  at  the  “4-2-1”  progression.  This  approximation  results  in  a  “maintenance”  hourly  value  providing  the  necessary  intake  to  meet  a  minimum  of  one's  basal  metabolic  needs,  but  likely  not  those  accompanying  routine  physical  activities.  It  is  worth  noting  that  this  formula  was  developed  based  on  data  from  hospitalized,  bedridden  patients.1  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accesspediatrics.mhmedical.com/content.aspx?aid=1152488434
ER  -