儿童液体疗法（英文版）

1、,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,Infantile Liquid Therapy,Objective,Summary,Characteristic of Infantile Body Fluid Balance,Fluid,Electrolyte,&Acid-base Disorders,Common Solution,of,Liquid Therapy,Infantile Diarrhea Liquid Therapy,Objective,Characteristic of Infantile Body Fluid Balance,Realized,Pathophysiology of Infantile Fluid,Electrolyte&Acid-base Imbalance,Be familiar with,Clinical menifestations of Infantile Fluid,Electrolyte&Acid-base Disorders,Mastered,Common Solution Componen

2、t of Liquid Therapy,Be familiar with,Liquid Therapy of Infantile Diarrhea,Mastered,Summary,Body fluid is important component of human body and the physiological equilibrium of body fluid is an important factor for human living.The dynamic equilibrium of fluid,electrolyte,acid-base,osmotic pressure depends on normal regulating function of nerve,incretion,lung and kidney.Because of the infantile physiologic peculiarity,These systematic functions are easily affected by diseases and/or environment a

3、nd are maladjusted.Therefore,the disorder of water,electrolyte and acid-base is common in pediatric clinic.,Characteristic,of Infantile Body Fluid Balance,A.,Total body water&its distribution,Body water compartments related to age(total body mass%),Age,TBW,ECF,ICF,Plasma,ISF,Newborn infant,78,6,37,35,1,year,70,5,25,40,214,years,66,5,20,40,Adult,5566,5,1015,4045,TBW:,total body water ECF:extracellular fluid,ICF:intracellular fluid ISF:interestitial fluid,Characteristic,of,Infantile,Body,Fluid,Bal

4、ance,B.Electrolyte composition of body fluid,ECF:,Na,+,、,Cl,-,，HCO,3,-,ICF:,K,+,、Mg,2+,、HPO,4,2,-,、Protein,C.Water metabolism,a.,Large water requirements,swift water exchange,unobvious,water loss(double adults amount).Infants water exchange amount is,1/2,of ECF,the adults is just,1/7,.,b.,Immature body liquid regulating function,immature concentration and dilution function of infantile.,Fluid,Electrolyte&Acid-base Disorders,A.Degree of dehydration,Dehydration,Mild,Moderate,Severe,Decrease in,bod

5、y weight,5,(50ml,/,kg),510,(50,100,ml,/,kg),10,(100,120,ml,/,kg),Psyche,Depressed,hyperirritable,Depressed,hyperirritable,Lethargic,coma,Orbit,Fontanel,Sunken,Sunken,Severely sunken,Skin turgor,Normal,Decrease,Markedly decrease,Mucous membranes,Dry,Dry,Severely dry,Tears,Decrease,Decrease,Absent,Urine,Mild oliguria,oliguria,Anuria,Blood pressure,Normal,Normal,Low,Type of dehydration,Pathogeny,Serum sodium,Pathophysiology&,clinical characteristic,Isosmotic,Acute gastrointestinal fluid lose,130150

6、,mmol,/,L,ECF:decrease,Osmotic pressure,(intracellular=extracellular),Dehydrant volume accord with dehydrant physical sign,Hypotonic,Chronic gastrointestinal fluid lose,150,mmol,/,L,ICF:severely decrease,Milder dehydrant sign than the other two kinds,Fluid,Electrolyte&Acid-base Disorders,B.Property of dehydration,C.Metabolic acidosis,Pathogeny,1.The lose of large amount of basic substances,（,gastrointestinal tract,kidneys,）,2.,Too much Acid metabolite,（,hungriness,diabetes,renal failure,hypoxia,

7、）,3.Too much acid substance intake,（,long time to take calcium chloride,ammonium chloride,amino acid,etc.,）,Degree,Mild,HCO,3,-,1813,mmol,/,L,Moderate,HCO,3,-,139,mmol,/,L,Severe,HCO,3,-,9,mmol,/,L,Fluid,Electrolyte&Acid-base Disorders,D.Hypokalemia,Pathogeny,1.Lack of intake,2.,Loss of kalium from kidneys or gastrointestinal tract,3.,Burn,dialysis etc.,4.,Abnormal kalium distribution inside or outside cells,（,alkalosis,insulin therapy,、,periodic anesthesia,）,Fluid,Electrolyte&Acid-base Disorder

8、s,Clinical menifetation,1.,Nervous system,depressed,2.,Muscle,inertia of limbs,，,muscular tension down,，,severely,retardant paralysis,，,respiratory muscle paralysis,3.Heart,heart rate increasing,arrhythmia,Adams,Stokes,syndrome,heart rate decreasing,，,atrioventricular block,heart sound lowering,cardiogram:U wave appearing,，,UT，flattened T,wave,4.,Kidney,concentrating function lowering,urine volume increasing,Fluid,Electrolyte&Acid-base Disorders,Common Solution of Liquid Therapy,A.Nonelectrolyte

9、,solution,5、10,glucose,B.,Electrolyte,solution,0.9,NaCl,、1.4、5,NaHCO,3,、10,KCl,C.Mixed solutions,refer to the following table,Common mixed solution,0.9%,NaCl,1.4%,NaHCO,3,510%,G.S,2:1,2,1,3:2:1,2,1,3,4:3:2,4,2,3,6:2:1,2,1,6,Common Solution of Liquid Therapy,Infantile Diarrhea Liquid Therapy,A.Volume,Degree,Total volume,Cumulated losing volume,Keep transfusing period,（,physiological need,losing continuing,）,Mild,90,120,ml,/,kg,4560,ml,/,kg,4560,ml,/,kg,Moderate,120,150,ml,/,kg,6075,ml,/,kg,6075,m

10、l,/,kg,Severe,150,180,ml,/,kg,7590,ml,/,kg,7590,ml,/,kg,B.Quality,Dehydrant category,Cumulated losing volume,Keep transfusing period,（,physiological need,losing continuing,）,Hypotonic dehydration,4:3:2,1,/,31,/,4,Sodic solution,Isosmotic dehydration,3:2:1,1,/,31,/,4,Sodic solution,Hyperosmotic,dehydration,1/3,Sodic solution,1,/,31,/,4,Sodic solution,Infantile Diarrhea Liquid Therapy,C.Speed,Total volume,Cumulated losing volume,Keep transfusing period,（,physiological need,losing continuing,）,24,h

《儿童液体疗法（英文版）》由会员第***分享，可在线阅读，更多相关《儿童液体疗法（英文版）》请在金锄头文库上搜索。