🧒 Pediatric Diabetic Ketoacidosis Fluids (DKA)
UseUse in children with DKA to compute the initial bolus, the 48-hour fluid rate, the insulin infusion rate and …
SourceGlaser N, et al. ISPAD Clinical Practice Consensus Guidelines 2022: DKA and HHS. Pediatr Diabetes 2…
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
Insulin is started about one hour after fluids begin and is never given as an IV bolus, reducing the risk of rapid osmotic shifts.
When to use
Use in children with DKA to compute the initial bolus, the 48-hour fluid rate, the insulin infusion rate and potassium replacement.
How it works
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].
Key points
- 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.
References
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
Verification & sources · governance
FAQ
Frequently asked questions
- 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.