Pediatric Diabetic Ketoacidosis Fluids (DKA) — free guideline decision tool
This calculator structures pediatric diabetic ketoacidosis fluid and insulin therapy by the ISPAD framework: initial bolus, deficit-plus-maintenance replacement over 24–48 hours, insulin infusion and potassium.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Weight (cap per local protocol) | 20 kg |
|---|---|
| Degree of dehydration | ~ 7% (moderate) |
| Shock / hypotension | No |
→Fluid rate (48 h)92 mL/h
- Initial bolus：=200–400mL isotonic fluid (over 20–30 min, max [pending update]). Resuscitation boluses are not subtracted from the deficit
- Fluid deficit：Estimated at 7% = 1400 mL; replaced together with maintenance over 24–48 h (here over 48 h)
- Maintenance：1500 mL/day (Holliday-Segar), 3000 mL over 48 h
| Weight (cap per local protocol) | 20 kg |
|---|---|
| Degree of dehydration | ~ 5% (mild) |
| Shock / hypotension | No |
→Fluid rate (48 h)83 mL/h
- Initial bolus：=200–400mL isotonic fluid (over 20–30 min, max [pending update]). Resuscitation boluses are not subtracted from the deficit
- Fluid deficit：Estimated at 5% = 1000 mL; replaced together with maintenance over 24–48 h (here over 48 h)
- Maintenance：1500 mL/day (Holliday-Segar), 3000 mL over 48 h
Common questions
What is Pediatric Diabetic Ketoacidosis Fluids (DKA)?
This calculator structures pediatric diabetic ketoacidosis fluid and insulin therapy by the ISPAD framework: initial bolus, deficit-plus-maintenance replacement over 24–48 hours, insulin infusion and potassium.
How is Pediatric Diabetic Ketoacidosis Fluids (DKA) calculated? What is the core formula?
Initial isotonic bolus (shock 10/dose, repeat up to 40); deficit = % dehydration × weight; total = deficit + 2× Holliday-Segar maintenance, given over 48 h; insulin started 1 h after fluids, no bolus; KCl/L; weight [pending update].
When is Pediatric Diabetic Ketoacidosis Fluids (DKA) used?
Use in children with DKA to compute the initial bolus, the 48-hour fluid rate, the insulin infusion rate and potassium replacement.
What are the key clinical points for Pediatric Diabetic Ketoacidosis Fluids (DKA)?
Insulin is started about one hour after fluids begin and is never given as an IV bolus, reducing the risk of rapid osmotic shifts. Resuscitation boluses are not subtracted from the calculated deficit, and dextrose is added once glucose falls to roughly/L. Deteriorating consciousness, headache, bradycardia or rising blood pressure signals possible cerebral edema, treated with mannitol or hypertonic saline and CT imaging.
What are the limits and cautions when using Pediatric Diabetic Ketoacidosis Fluids (DKA)?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
Does Pediatric Diabetic Ketoacidosis Fluids (DKA) upload patient data? Where is it calculated?
Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
How is Pediatric Diabetic Ketoacidosis Fluids (DKA) calculated in practice? Can you show a worked example?
Inputs: Weight (cap per local protocol) 20 kg, Degree of dehydration ~ 7% (moderate), Shock / hypotension No → Result: Fluid rate (48 h) 92 mL/h（Initial bolus: =200–400mL isotonic fluid (over 20–30 min, max [pending update]). Resuscitation boluses are not subtracted from the deficit, Fluid deficit: Estimated at 7% = 1400 mL; replaced together with maintenance over 24–48 h (here over 48 h), Maintenance: 1500 mL/day (Holliday-Segar), 3000 mL over 48 h） Inputs: Weight (cap per local protocol) 20 kg, Degree of dehydration ~ 5% (mild), Shock / hypotension No → Result: Fluid rate (48 h) 83 mL/h（Initial bolus: =200–400mL isotonic fluid (over 20–30 min, max [pending update]). Resuscitation boluses are not subtracted from the deficit, Fluid deficit: Estimated at 5% = 1000 mL; replaced together with maintenance over 24–48 h (here over 48 h), Maintenance: 1500 mL/day (Holliday-Segar), 3000 mL over 48 h）
Run Pediatric Diabetic Ketoacidosis Fluids (DKA) now
This calculator structures pediatric diabetic ketoacidosis fluid and insulin therapy by the ISPAD framework: initial bolus, deficit-plus-maintenance replacement over 24–48 hours, insulin infusion and potassium.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.