儿童液体疗法英文
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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
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，U≥T， flattened T wave 4. Kidney—— concentrating function lowering, urine volume increasing
Degree
Total volume
Cumulated losing volume
Mild 90～120ml/kg 45～60ml/kg
Keep transfusing period （physiological need, losing continuing）
45～60ml/kg
Moderate 120～150ml/kg 60～75ml/kg
• 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 and are maladjusted. Therefore, the disorder of water, electrolyte and acid-base is common in pediatric clinic.
Lethargic, coma
Orbit, Fontanel
Skin turgor Mucous
membranes
Tears
Sunken ± Normal ±
Dry ± Decrease ±
Sunken Decrease
Dry Decrease
Severely sunken Markedly decrease
Common Solution of Liquid Therapy
Common mixed solution
0.9% NaCl
1.4% NaHCO3
2:1
2
1
5~10%G.S －
3:2:1
2
1
3
4:3:2
4
2
3
6:2:1
2
1
6
Infantile Diarrhea Liquid Therapy
A. Volume
Characteristic of Infantile Body Fluid Balance
A. Total body water & its distribution
Body water compartments related to age (total body mass%)
ECF
Age
TBW
ICF
Plasma ISF
Newborn infant
78
6
37
35
1 year
70
5
25
40
2～14 years
66
5
20
40
Adult
55～66
5
10～15 40～45
TBW: total body water ICF: intracellular fluid
ECF: extracellular fluid ISF: interestitial fluid
Dehydration Decrease in body weight
Psyche
Mild
5％
(50ml / kg)
Depressed, hyperirritable
Moderate
5～10％
(50～100ml / kg)
Depressed, hyperirritable
Severe
>10％
(100～120ml / kg)
Common Solution of Liquid Therapy
A. Nonelectrolyte solution
5％、10％ glucose
B. Electrolyte solution
0.9％ NaCl、1.4％、5％ NaHCO3、10％ KCl
C. Mixed solutions
refer to the following table
Type of dehydration
Pathogeny
Serum sodium
Isosmotic
Acute gastrointestinal
fluid lose
130～150 mmol / L
Hypotonic
Chronic gastrointestinal
fluid lose
<130 mmol / L
Байду номын сангаасECF: severely decrease, Easily shock ，
Severer dehydrant sign than the other two kinds
Hyperosmotic
High grade fever, Infection
>150 mmol / L
ICF: severely decrease,
60～75ml/kg
Severe 150～180ml/kg 75～90ml/kg
75～90ml/kg
Infantile Diarrhea Liquid Therapy
B. Quality
Dehydrant category
Cumulated losing volume
Keep transfusing period
Severely dry Absent
Urine Blood pressure
Mild oliguria Normal
oliguria Normal
Anuria Low
Fluid, Electrolyte & Acid-base Disorders
B. Property of dehydration
2. Too much Acid metabolite （hungriness, diabetes, renal failure, hypoxia）
3. Too much acid substance intake （long time to take calcium chloride, ammonium chloride, amino acid etc.）
Characteristic of Infantile Body Fluid Balance
B. Electrolyte composition of body fluid
ECF: Na+ 、 Cl-，HCO3 ICF: K + 、Mg 2+ 、HPO4 2-、Protein
C. Water metabolism
（alkalosis, insulin therapy、periodic anesthesia）
Fluid, Electrolyte & Acid-base Disorders
Clinical menifetation
1. Nervous system ——depressed 2. Muscle——inertia of limbs，muscular tension down，severely
（physiological need, losing continuing）
Hypotonic dehydration
4:3:2
1/3～1/4
Sodic solution
Isosmotic dehydration
3:2:1
1/3～1/4
Sodic solution
Hyperosmotic dehydration
Pathophysiology &
clinical characteristic
ECF: decrease, Osmotic pressure (intracellular = extracellular) Dehydrant volume accord with dehydrant physical sign
Degree Mild Moderate Severe
HCO3HCO3HCO3-
18~13 mmol / L 13~9 mmol / L <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
Milder dehydrant sign than the other two kinds
Fluid, Electrolyte & Acid-base Disorders
C. Metabolic acidosis
Pathogeny
1. The lose of large amount of basic substances（gastrointestinal tract, kidneys）
1/3 Sodic solution
1/3～1/4
Sodic solution
Infantile Diarrhea Liquid Therapy
C. Speed
Total volume 24 h －
Cumulated losing volume
8～12 h
Keep transfusing period （physiological need, losing continuing）
a. Large water requirements, swift water exchange, unobvious water loss (double adult’s amount ). Infant’s water exchange amount is 1 / 2 of ECF , the adult’s is just 1 / 7.
• Clinical menifestations of Infantile Fluid , Electrolyte
& Acid-base Disorders
——Mastered
• Common Solution Component of Liquid Therapy
——Be familiar with
Objective
• Characteristic of Infantile Body Fluid Balance
——Realized
• Pathophysiology of Infantile Fluid, Electrolyte & Acid-
base Imbalance
——Be familiar with
b. Immature body liquid regulating function , immature concentration and dilution function of infantile.
Fluid, Electrolyte & Acid-base Disorders
A. Degree of dehydration
Objective Summary Characteristic of Infantile Body Fluid Balance Fluid, Electrolyte, & Acid-base Disorders Common Solution of Liquid Therapy Infantile Diarrhea Liquid Therapy
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，U≥T， flattened T wave 4. Kidney—— concentrating function lowering, urine volume increasing
Degree
Total volume
Cumulated losing volume
Mild 90～120ml/kg 45～60ml/kg
Keep transfusing period （physiological need, losing continuing）
45～60ml/kg
Moderate 120～150ml/kg 60～75ml/kg
• 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 and are maladjusted. Therefore, the disorder of water, electrolyte and acid-base is common in pediatric clinic.
Lethargic, coma
Orbit, Fontanel
Skin turgor Mucous
membranes
Tears
Sunken ± Normal ±
Dry ± Decrease ±
Sunken Decrease
Dry Decrease
Severely sunken Markedly decrease
Common Solution of Liquid Therapy
Common mixed solution
0.9% NaCl
1.4% NaHCO3
2:1
2
1
5~10%G.S －
3:2:1
2
1
3
4:3:2
4
2
3
6:2:1
2
1
6
Infantile Diarrhea Liquid Therapy
A. Volume
Characteristic of Infantile Body Fluid Balance
A. Total body water & its distribution
Body water compartments related to age (total body mass%)
ECF
Age
TBW
ICF
Plasma ISF
Newborn infant
78
6
37
35
1 year
70
5
25
40
2～14 years
66
5
20
40
Adult
55～66
5
10～15 40～45
TBW: total body water ICF: intracellular fluid
ECF: extracellular fluid ISF: interestitial fluid
Dehydration Decrease in body weight
Psyche
Mild
5％
(50ml / kg)
Depressed, hyperirritable
Moderate
5～10％
(50～100ml / kg)
Depressed, hyperirritable
Severe
>10％
(100～120ml / kg)
Common Solution of Liquid Therapy
A. Nonelectrolyte solution
5％、10％ glucose
B. Electrolyte solution
0.9％ NaCl、1.4％、5％ NaHCO3、10％ KCl
C. Mixed solutions
refer to the following table
Type of dehydration
Pathogeny
Serum sodium
Isosmotic
Acute gastrointestinal
fluid lose
130～150 mmol / L
Hypotonic
Chronic gastrointestinal
fluid lose
<130 mmol / L
Байду номын сангаасECF: severely decrease, Easily shock ，
Severer dehydrant sign than the other two kinds
Hyperosmotic
High grade fever, Infection
>150 mmol / L
ICF: severely decrease,
60～75ml/kg
Severe 150～180ml/kg 75～90ml/kg
75～90ml/kg
Infantile Diarrhea Liquid Therapy
B. Quality
Dehydrant category
Cumulated losing volume
Keep transfusing period
Severely dry Absent
Urine Blood pressure
Mild oliguria Normal
oliguria Normal
Anuria Low
Fluid, Electrolyte & Acid-base Disorders
B. Property of dehydration
2. Too much Acid metabolite （hungriness, diabetes, renal failure, hypoxia）
3. Too much acid substance intake （long time to take calcium chloride, ammonium chloride, amino acid etc.）
Characteristic of Infantile Body Fluid Balance
B. Electrolyte composition of body fluid
ECF: Na+ 、 Cl-，HCO3 ICF: K + 、Mg 2+ 、HPO4 2-、Protein
C. Water metabolism
（alkalosis, insulin therapy、periodic anesthesia）
Fluid, Electrolyte & Acid-base Disorders
Clinical menifetation
1. Nervous system ——depressed 2. Muscle——inertia of limbs，muscular tension down，severely
（physiological need, losing continuing）
Hypotonic dehydration
4:3:2
1/3～1/4
Sodic solution
Isosmotic dehydration
3:2:1
1/3～1/4
Sodic solution
Hyperosmotic dehydration
Pathophysiology &
clinical characteristic
ECF: decrease, Osmotic pressure (intracellular = extracellular) Dehydrant volume accord with dehydrant physical sign
Degree Mild Moderate Severe
HCO3HCO3HCO3-
18~13 mmol / L 13~9 mmol / L <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
Milder dehydrant sign than the other two kinds
Fluid, Electrolyte & Acid-base Disorders
C. Metabolic acidosis
Pathogeny
1. The lose of large amount of basic substances（gastrointestinal tract, kidneys）
1/3 Sodic solution
1/3～1/4
Sodic solution
Infantile Diarrhea Liquid Therapy
C. Speed
Total volume 24 h －
Cumulated losing volume
8～12 h
Keep transfusing period （physiological need, losing continuing）
a. Large water requirements, swift water exchange, unobvious water loss (double adult’s amount ). Infant’s water exchange amount is 1 / 2 of ECF , the adult’s is just 1 / 7.
• Clinical menifestations of Infantile Fluid , Electrolyte
& Acid-base Disorders
——Mastered
• Common Solution Component of Liquid Therapy
——Be familiar with
Objective
• Characteristic of Infantile Body Fluid Balance
——Realized
• Pathophysiology of Infantile Fluid, Electrolyte & Acid-
base Imbalance
——Be familiar with
b. Immature body liquid regulating function , immature concentration and dilution function of infantile.
Fluid, Electrolyte & Acid-base Disorders
A. Degree of dehydration