Fluid Balance Calculation in Pediatric Patients

Components of Fluid Balance Calculation

• The American Academy of Pediatrics recommends including intravenous fluids, oral intake, medications, and flushes, as well as parenteral nutrition in fluid balance calculations 1, 2
• Urine output is a primary component of fluid balance calculation, and should be monitored along with other outputs such as insensible losses and other losses 1, 2

Special Considerations in Pediatric Populations

• The American Academy of Pediatrics notes that premature and term neonates have higher body water content, making fluid balance particularly critical 2
• Water turnover is higher in neonates and decreases with age, according to the American Academy of Pediatrics 2
• Renal function maturation affects fluid handling, with maximum urinary concentration limited to 550 mosm/L in preterm infants and 700 mosm/L in term infants 2

Practical Approach to Fluid Balance Calculation

• The Journal of Clinical Oncology recommends measuring and recording all fluid inputs, including IV, oral, and medications 1
• The Clinical Nutrition journal suggests considering insensible losses based on age and clinical condition when calculating fluid balance 2