3.7.1 Rapid Hydration Document

Rapid hydration may be used at the discretion of the Satellite physician/Nurse Practitioner for doses of cyclophosphamide ≥500mg/m2.

Exclusion criteria:

• Patients less than twelve months of age
• Patients with a history of severe renal, cardiac or pulmonary impairment
• Patients without central venous access

For Cyclophosphamide equal to or greater than 500mg/m2:

Administer 0.9% NaCl 750mL/m2 IV over one hour*

Proceed with chemotherapy once urine specific gravity (SG) 1.010 or less.

If urine SG is greater than 1.010 post bolus then immediately give second bolus of 300mL/m2 over 30 min.  Proceed to chemotherapy if urine specific gravity is 1.010 or less post second bolus.

If urine parameters are still not met, discuss with Satellite NP/MD caring for patient.

*If hourly rate exceeds 999 mL/hr, infuse entire volume at 1000 mL/hr until infusion complete.

Primary author Ms. Denise Reniers, Children’s Hospital, London Health Sciences Centre, London with input from Ms. Tracey Taylor, The Hospital for Sick Children, Toronto, Mr. John Wiernikowski, McMaster Children’s Hospital, Hamilton Health Sciences Centre, Hamilton, Dr. Arif Maji, Southlake Regional Health Centre, Newmarket and Ms. Kirsty Morelli, Rouge and Scarborough Hospital, Scarborough. Reviewed by the POGO Satellite Manual Pharmacy Working Group, 2016.