Ferrero F C, Ossorio M F, Voyer L E, González H, Macario M F, Cabeza M
4a. Cátedra de Pediatría, Universidad de Buenos Aires, Hospital General de Niños Pedro de Elizalde, Argentina.
Bol Med Hosp Infant Mex. 1991 Jul;48(7):474-8.
Twenty-two infants with moderate dehydration due to diarrhea in whom oral rehydration therapy (ORT) was contraindicated or who failed to respond to this method of therapy were treated with rapid intravenous rehydration (RIR). Clinical signs of dehydration without shock allowed us to estimate 5% to 10% of weight loss. Patients were 11 days to 19 months old, and 9 of them were undernourished. A standard solution containing 90 mmol/L sodium, 80 mmol/L chloride, 30 mmol/L bicarbonate, 20 mmol/L potassium and 111 mmol/L glucose was used for all patients. The IV infusion was maintained until the rehydration was completed at a rate of 15 to 20 mL/kg/hour. Complete rehydration was successfully achieved in all patients. A total of 89.5 +/- 25.0 mL/kg (mean +/- SD) was needed and the duration of the IV infusion was 5.1 +/- 1.6 hours. Weight gain achieved was 6.5 +/- 1.6%. None of the patients developed hypernatremia following treatment. The initial base deficit, -9.5 +/- 6.6, was reduced to -3.5 +/- 2.9. All of the patients tolerated refeeding immediately after completion of the IV infusion. Our study suggests that this modality of rehydration is well tolerated, safe and effective and enhances the possibility of an early hospital discharge.
22例因腹泻导致中度脱水的婴儿,口服补液疗法(ORT)对其不适用或对该疗法无反应,遂采用快速静脉补液(RIR)进行治疗。无休克的脱水临床体征使我们能够估计体重减轻5%至10%。患者年龄为11天至19个月,其中9例营养不良。所有患者均使用含90 mmol/L钠、80 mmol/L氯、30 mmol/L碳酸氢盐、20 mmol/L钾和111 mmol/L葡萄糖的标准溶液。静脉输注以15至20 mL/kg/小时的速度维持,直至补液完成。所有患者均成功实现完全补液。总共需要89.5±25.0 mL/kg(平均值±标准差),静脉输注持续时间为5.1±1.6小时。体重增加6.5±1.6%。治疗后无一例患者发生高钠血症。初始碱缺失从-9.5±6.6降至-3.5±2.9。所有患者在静脉输注完成后立即耐受重新喂养。我们的研究表明,这种补液方式耐受性良好、安全有效,并增加了早期出院的可能性。