What is the recommended fluid bolus for children presenting with dehydration?

The recommended fluid bolus for children presenting with dehydration is 20 mL/kg of isotonic solution. This choice is based on the need to quickly restore intravascular volume and improve tissue perfusion in children who are dehydrated. Isotonic solutions, such as normal saline or lactated Ringer's, effectively replace lost fluids without causing osmotic imbalances.

When a child is dehydrated, they typically have a deficit of both water and electrolytes. Administering an isotonic solution allows for effective rehydration while maintaining normal osmotic balance. The volume of 20 mL/kg is a standard recommendation that reflects the urgent need to restore fluid levels responsibly and safely.

Other types of solutions, such as hypotonic or hypertonic solutions, are not appropriate for bolusing in the initial management of dehydration. Hypotonic solutions could further exacerbate hyponatremia and other electrolyte imbalances, while hypertonic solutions may lead to fluid overload and worsen dehydration. The choice of isotonic solution at this specific volume ensures rapid and effective treatment to stabilize the child’s condition.