tailieunhanh - A Lange Medical Book Pediatrics on call - part 8

tinh thể thường được sử dụng điện giải (mEq / L) chất lỏng D5W (dextrose 5% trong nước) (10% dextrose trong nước) D20W (20% dextrose trong nước) D50W (50% dextrose trong nước) 1 2 / NS (0,45% NaCl) NS (0,9% NS) 3% NS D51/4NS D51 / 2 NS | 2. DEFICIT REPLACEMENT 545 TABLE IV-4. COMPOSITION AND DAILY PRODUCTION OF BODY FLUIDS Electrolytes mEq L __ __ Average Daily Fluid Na Cl- K hco3 Production mL Sweat 50 40 5 0 Varies Saliva 60 15 26 50 1500 Gastric juices 60-100 100 10 0 1500-2500 Duodenum 130 90 5 0-10 300-2000 Bile 145 100 5 15 100-300 Pancreatic juice 140 75 5 115 100-800 Ileum 140 100 2-8 30 100-9000 Diarrhea 120 90 25 45 Modified and reproduced with permission from Gomella LG Haist SA eds. Clinician s Pocket Reference 10th ed. McGraw-Hill. Copyright 2002. TABLE IV-5. COMPOSITION OF COMMONLY USED CRYSTALLOID SOLUTIONS Electrolytes mEq L Fluid Glucose g L Na Cl- K Ca HCO- kcal L D5W 5 50 170 dextrose in water D10W 10 100 340 dextrose in water D20W 20 200 680 dextrose in water D50W 50 500 1700 dextrose in water 1 2 NS 77 77 NaCl NS 154 154 NS 3 NS 513 513 D51 4NS 50 38 38 170 D51 2 NS 50 77 77 170 NaCl D5 NS 50 154 154 170 NaCl D5LR 5 50 130 110 4 3 27 180 dextrose in LR LR 130 110 4 3 27 10 NS normal saline LR lactated Ringer. Modified and reproduced with permission from Gomella LG Haist SA eds. Clinician s Pocket Reference 10th ed. McGraw-Hill. Copyright 2004. 546 IV FLUIDS AND ELECTROLYTES Patients receiving fluid and electrolyte replacement therapy should be closely monitored. Accurate recording of intake and output and weight monitoring of blood chemistries and assessment of vital signs and clinical status are important to prevent over- or underhydration. REFERENCES Boineau FG Lewy JE. Estimation of parenteral fluid requirements. Pediatr Clin North Am 1990 37 257-264. Greenbaum LA. Pathophysiology of body fluids and fluid therapy. In Behrman RE Kliegman RM Jenson HB eds. Nelson Textbook of Pediatrics 17th ed. Saunders 2004 190. Haist SA Robbins JB. Internal Medicine On Call 3rd ed. McGraw-Hill 2002. Hill LL. Body composition normal electrolyte concentrations and the maintenance of normal volume tonicity and acid-base metabolism. Pediatr Clin .