To calculate maintenance fluids when a patient is NPO, you can take the patient’s body weight in Kilograms, and use the following equation: (Kg – 20) + 60 = mL/hr. When a patient is NPO, maintenance fluids keep the patient hydrated. Those admitted with dehydration, mild hyponatremia, or acute renal failure will usually require maintenance fluids in order to slowly correct their hydration, sodium levels, and renal function. Those with burns or pancreatitis often require a large volume of fluids. The same goes for those with drains experiencing significant drainage. Those experiencing frequent vomiting or diarrhea require increased fluid to account for their ongoing water losses in their vomit or stool. Fevers commonly require increased maintenance fluid, as they cause “insensible water losses” from sweating and overall increased metabolism. Ongoing fluid losses commonly occur with various medical conditions. Patients who are NPO (nothing by mouth) are commonly ordered maintenance fluids, as well as those with ongoing fluid losses. Maintenance fluids are intravenous fluids that are run at a slower rate, usually to account for decreased PO intake or expected fluid losses. In the ER, I commonly order Intravenous fluid to those with nausea and vomiting, diarrhea, dehydration, acute kidney injury, abdominal pain, headaches, bleeding, or infections. IV fluids can also be used as maintenance fluids for those who are not able to intake enough hydration throughout the day.
Additionally, they can be used to support blood pressure in those with hypotension or sepsis. Most frequently, IV fluids are used to hydrate those with dehydration. Intravenous fluids are very commonly used in healthcare settings.
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