How to rehydrate hypertonic dehydration?

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Although diarrhea is a common disease in pediatrics, we must take more care and maintenance of our body on weekdays, but when we encounter severe diseases, such as hypertonic dehydration, we still need to carry out "tutorial". Let's share how to rehydrate hypertonic dehydration?.

How to rehydrate hypertonic dehydration?

First, intravenous infusion: intravenous sugar salt mixture, 2:1 solution, 20 ml / kg, intravenous injection or rapid infusion within 30 ~ 60 min, in order to rapidly increase blood volume and improve circulation and renal function; After volume expansion, according to the nature of dehydration (2:3:1 solution for isotonic dehydration and 4:3:2 solution for hypotonic dehydration), intravenous drip was continued at the rate of 80 ml / kg, and 2 / 3 volume was added first, for infants for 5 hours and older children for 2.5 hours. During the process of fluid replacement, the patient's dehydration was evaluated again every 1-2 hours, Skin elasticity increases, dryness decreases, crying is powerful, urination occurs, blood pressure rises, etc.) If there is no improvement, the speed of rehydration should be accelerated. Infants should reevaluate dehydration 6 hours after rehydration, and children should choose the appropriate rehydration program to continue treatment.

Second, correct acidosis: mild to moderate acidosis can be corrected by improving circulation and renal function with the input of mixed alkaline liquid; Severe acidosis should be corrected with another alkaline liquid. 5% sodium bicarbonate ml = (22 - HCO3 mmol / L) × Body weight (kg), or = be × zero point five × Body weight (kg). 1.7 ml of 5% sodium bicarbonate solution is needed to supplement 1 mmol of alkali, that is, 1 ml of 5% sodium bicarbonate solution is 0.6 mmol.

Third: correct hypokalemia: usually 4-6 hours before treatment or urination after infusion, can start to supplement potassium. Generally, according to the dosage of 2-4 mmol / kg per day, potassium deficiency can be increased to 4-6 mmol / kg, and the concentration of potassium chloride intravenous drip is usually 0.2%, not more than 0.3%. Potassium supplement time should not be less than 8 hours. In case of obvious potassium deficiency, potassium supplement should be continued for more than 4-6 days. Generally, 1 / 2 amount should be added in 24 hours first, and then potassium supplement should be continued as appropriate.

matters needing attention

4: 3:2 sodium containing solution, 3 phr glucose + 4 phr normal saline + 2 phr 1.4% sodium bicarbonate, glucose enters the body and is used in the cells quickly, so the molecular number is 6, the volume is 9, and the tension is 2 / 3, which is used to supplement the accumulated loss of hypotonic dehydration.