Seaman S L
Neonatal Netw. 1995 Aug;14(5):5-11.
The comprehension of fluid and electrolyte and acid-base homeostasis is essential for the nurse caring for critically-ill neonates. This article discusses the means by which the kidney regulates fluid, sodium, and potassium, and its role in acid-base regulation. Under normal circumstances, the neonatal kidney is able to maintain homeostasis in these areas. However, the more premature an infant, the less able they are to maintain normal electrolyte, bicarbonate, or fluid balance. The understanding of renal filtration, absorption, and excretion requires knowledge of renal anatomy and the structure and function of the nephron unit. Regulation of glomerular filtration and renal blood flow plays an important part in determining the kidney's ability to maintain homeostasis (see Part I). Perhaps the greatest factor in determining renal function is the degree of maturity. Nephrogenesis is not complete until the 34th week of gestation. This, along with other factors, has a profound effect on glomerular filtration, renal filtration and absorption, and the nephron's sensitivity to hormonal control. The structural and functional differences in the neonatal kidney must be considered when evaluating renal function and devising a plan of care.
对于护理危重新生儿的护士而言，理解体液、电解质及酸碱平衡至关重要。本文讨论了肾脏调节液体、钠和钾的方式及其在酸碱调节中的作用。在正常情况下，新生儿的肾脏能够在这些方面维持平衡。然而，婴儿越早早产，其维持正常电解质、碳酸氢盐或液体平衡的能力就越弱。理解肾脏的滤过、重吸收和排泄需要了解肾脏解剖结构以及肾单位的结构和功能。肾小球滤过和肾血流量的调节在决定肾脏维持平衡的能力方面起着重要作用（见第一部分）。也许决定肾功能的最大因素是成熟程度。肾发生直到妊娠第34周才完成。这一点与其他因素一起，对肾小球滤过、肾脏滤过和重吸收以及肾单位对激素控制的敏感性产生深远影响。在评估肾功能和制定护理计划时，必须考虑新生儿肾脏的结构和功能差异。
