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This document provides guidance on hydro-electrolytic and acid-base rebalancing for a child with moderate to severe dehydration. It outlines administering 10 ml/kg of dextran intravenously over 15 minutes to combat collapse, followed by 15 ml/kg of sodium bicarbonate over 45 minutes to combat acidosis. It recommends administering half of fluid losses in the first 4 hours then meeting maintenance needs of 100 ml/kg over the next 20 hours through two identical intravenous bags administered at different rates over 8 and 12 hours.
This document provides guidance on hydro-electrolytic and acid-base rebalancing for a child with moderate to severe dehydration. It outlines administering 10 ml/kg of dextran intravenously over 15 minutes to combat collapse, followed by 15 ml/kg of sodium bicarbonate over 45 minutes to combat acidosis. It recommends administering half of fluid losses in the first 4 hours then meeting maintenance needs of 100 ml/kg over the next 20 hours through two identical intravenous bags administered at different rates over 8 and 12 hours.
This document provides guidance on hydro-electrolytic and acid-base rebalancing for a child with moderate to severe dehydration. It outlines administering 10 ml/kg of dextran intravenously over 15 minutes to combat collapse, followed by 15 ml/kg of sodium bicarbonate over 45 minutes to combat acidosis. It recommends administering half of fluid losses in the first 4 hours then meeting maintenance needs of 100 ml/kg over the next 20 hours through two identical intravenous bags administered at different rates over 8 and 12 hours.
bicarbonat 14 %o 15X10=150 ml NaHCO3 14 %o Ritmul de administrare=cantitatea de lichid ce trebuie admin. X 20 (nr. pic. dintr- un ml) / timpul in minute= numarul de picaturi/minut. Ritmul de administrare=150X20/45=60 picaturi/min. Solutia de bicarbonat de 8.4% este de 6X mai concentrata decat cea de 1.4%; se dilueaza cu SF 9%o astfel: o parte NaHCO3 8.4%+5 parti de SF 9%o.
IN PRIMELE 4 ORE SE ADMINISTREAZA ½ DIN PIERDERI
Daca pierderile sunt de 10 % (in situatiile severe), pacientul nostru de 10 Kg va avea nevoie de 1000 ml, deci in primele 4 ore ii vom administra 500 ml. In prima ora a primit 100 ml+150 ml=250 ml. Deci in urmatoarele 3 ore va primi diferenta de 250 ml. Aceasta cantitate va fi reprezentata de SF 9%o si SG5% in parti egale (SF9%o-125 ml+SG5% -125 ml).
IN URMATOARELE 20 DE ORE SE ADMINISTREAZA NEVOILE
DE INTRETINERE: 100 ml/Kgc Aceasta cantitate se administreaza in doua flacoane identice ca si cantitate si continut, doar ritmul de administrare difera; I flacon se administreaza in 8 ore, al doilea in 12 ore. Cum se calculeaza cantitatile?: Nevoile de intretinere=100X10=1000 ml/zi (SG 5%) NaCl 58.5%d=2-4 mEq/Kgc4X10=40 ml NaCl 58.5% KCl 74.5%d=2-3 mEq/Kgc3X10=30 ml KCl 74.5% Ca gluconic 10%d=1-2 ml/Kgc1X10=10 ml Cagluconic 10% MgSO4 (1f=2 m)d=0.1-0.2 ml/Kgc2 ml MgSO4 Flacoanele pentru perfuzie: I flacon8 ore SG 5% 500 ml NaCl 58.5% 20 ml KCl 74.5% 15 ml Cagluconic 10 % 5 ml MgSO4 1 ml Total=541 ml. Ritm perfuzie=541X20/8X60=22 picaturi/minut II flacon12 ore, identic cu primul, rimul=541X20/12X60=15 picaturi/minut.