Fluid protocol #2—conservative fluid management
euvolemia, hyperhydration, dehydration, weight gain, microangiopathy
DEHYDRATION, MICROANGIOPATHY
The conservative fluid protocol has been designed to align and integrate into existing practice patterns. Clinicians can manage children as they normally would with a target of euvolemia. In this pathway, children will undergo a protocolized baseline evaluation that includes reversal of dehydration, if present, and close laboratory monitoring (Fig. The conservative fluid management pathway leaves the decision to admit the child to the discretion of the clinical care team. If microangiopathy is present admission is encouraged. For inpatients and outpatients, laboratory monitoring should be performed a minimum of every 24 h until discharge criteria are met. If intravenous fluids are administered, the maximum rate is 100% of maintenance and the target is euvolemia and maintaining weight gain below < 5%. The pathway should be discontinued once the same criteria are achieved as for the hyperhydration pathway (Fig. 