IVF
Normal electrolytes and no evidence of dehydration
5% dextrose with 0.25% NaCl and 2 meq KCl per 100 mL
Moderate or severe dehydration
Higher NaCl concentrations (0.5% to normal saline) and higher rates of administration (1.5 to 2 times maintenance)
Ensure correction of bicarbonate level, as it may be a hypoventilation risk
Nasogastric tube
Surgery
Can be delayed 24-36 hr to rehydrate infant and correct electrolytes
Normal electrolytes and no evidence of dehydration
5% dextrose with 0.25% NaCl and 2 meq KCl per 100 mL
Moderate or severe dehydration
Higher NaCl concentrations (0.5% to normal saline) and higher rates of administration (1.5 to 2 times maintenance)
Ensure correction of bicarbonate level, as it may be a hypoventilation risk
5% dextrose with 0.25% NaCl and 2 meq KCl per 100 mL
Higher NaCl concentrations (0.5% to normal saline) and higher rates of administration (1.5 to 2 times maintenance)
Can be delayed 24-36 hr to rehydrate infant and correct electrolytes
Ensure that kidneys are functional prior to giving potassium
Do not give lactated ringers
May lead to worsening alkalosis > apnea in infants
May lead to worsening alkalosis > apnea in infants
Pyloric stenosis
Emergent
Gastric volvulus
Necrotizing Enterocolitis
Duodenal atresia
Volvulus
Achalasia
Testicular torsion