Table 5.

Intravenous Fluid Infusion Rates Used at the Queen Sirikit National Institute of Child Health, Bangkok

Patient status	Infusion rate(s)
Prolonged/profound shock (undetectable blood pressure)	Initial:  20 mL/kg normal saline over 15–20 min or until BP restored  Correct ABCS If no improvement:  Recheck hematocrit, colloid  If hematocrit falling: transfuse whole blood (10 mL/kg) or packed RBC (5 mL/kg) over 1 h  If organ failure, special management needed (see text) When blood pressure restored:  Follow recommendations under “Shock” below
Shock	Initial:  10 mL/kg/h isotonic crystalloid for 1–2 h If no improvement:  Check hematocrit and ABCS  Hematocrit rising: colloid 10 mL/kg/h  Hematocrit falling: transfusion (see above under “Profound shock”) When patient improves:  Stepwise reduction in infusion rate: 7, 5, 3, 1.5 mL/kg/h over 24–48 h
Nonshock (if inadequate oral intake)	Initial:  Hemoconcentration ≥20%: 3 mL/kg/h (80 mL/h for adults)  Hemoconcentration <20%: 1–2 mL/kg/h (20–40 mL/h for adults)

Abbreviations: ABCS; acidosis, bleeding, calcium, and sugar; BP, blood pressure; RBC, red blood cell.