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The preferred mode of rehydration for children should be enteral—using oral rehydration fluids containing replacement electrolytes. Intravenous (IV) replacement must only be used if a child cannot tolerate the volume of enteral fluid required, is nil-by-mouth or has an absorption problem.
Most indications for IV fluid replacement are the same for children and adults. Few indications specific to pediatrics are:
- Increased fluid losses in neonates with jaundice, undergoing phototherapy to conjugate bilirubin.
- Increased losses due to decreased thickness of the stratum corneum—greater risk in premature neonates.
- Decreased absorption of enteral feeds due to immature gastrointestinal function.
Isotonic fluids – sodium chloride 0.9% plus glucose 5%, should be given to pediatric patients with established hyponatremia. While fluid restriction can be used to reduce the amount of free water and compensate for the hyponatremia.
Source: Clinical Pharmacist. 2012, July. DOI:10.1211/PJ.2021.1.64703