Question

For pediatric patients, what volume of fluid resuscitation should be given initially in the setting of shock?

1) 750 mL of saline uniformly
2) 1 liter of saline
3) 20 mL/kg of 0.45
4) 10 to 20 mL/kg of Ringers lactate

Answer 1

In pediatric shock, the initial fluid resuscitation should be 10 to 20 mL/kg of an isotonic solution like Ringer's lactate, which mirrors the body's electrolyte composition to maintain fluid balance.

Step-by-step explanation:

For pediatric patients in the setting of shock, the initial volume of fluid resuscitation recommended is 10 to 20 mL/kg of an isotonic solution such as Ringer's lactate. The concentration of electrolytes in intravenous fluids like Ringer's lactate is designed to approximate the electrolyte composition of the body's fluids. This isotonic balance is crucial to maintaining proper fluid balance within cells and tissues without causing electrolyte imbalances or shifting of fluids between compartments abnormally.

Administering Ringer's lactate at a dose of 10 to 20 mL/kg ensures that children receive an appropriate volume based on their weight, which can help in cases of significant body fluid loss such as blood loss of at least 500 ml or 7 ml/kg for children. When correction of dehydration is required, a solution of ordinary NaCl or a mixture of isotonic saline and Na lactate can be employed effectively.