Fluidoterapia y electrolitos parenterales en pediatría

Autores/as

DOI:

https://doi.org/10.47464/MetroCiencia/vol28/4/2020/4-15

Palabras clave:

Pediatría, fluidoterapia, electrolítos, deshidratación, superficie corporal, soluciones, hipernatremia, hiponatremia

Resumen

La administración de líquidos y electrolitos parenterales es una terapia fundamental de soporte en niños agudamente enfermos si la vía oral no permite la administración de la cantidad o composición requeridas de fluidos, por ejemplo en enfermedades de tipo gastrointestinal, respiratorio, neurológico, o en el período transoperatorio. Al momento de planificar la administración de líquidos y electrolitos parenterales en niños a partir del mes de edad, se debe considerar componentes relacionados con la cantidad de líquidos a infundir considerando los requerimientos secundarios a pérdidas hídricas habituales o requerimientos para reacciones metabólicas, evaluar el grado de deshidratación para la administración de líquidos que complementen el déficit, corregir las pérdidas que se han producido secundarios a una noxa externa (enfermedad, procedimiento quirúrgico, trauma, etc.) y finalmente aportar la cantidad adecuada de fluido que permita re-establecer la perfusión tisular. Es necesario conocer los cambios instaurados basados en la evidencia actual con la finalidad de incorporar a el manejo frecuente de los pacientes considerando también la toxicidad ya sean cualitativos o cuantitativos de esta terapéutica tan necesaria en el manejo del paciente pediátrico.

Descargas

Los datos de descargas todavía no están disponibles.

Biografía del autor/a

Santiago Campos Miño, Hospital Metropolitano

UCI - Pediátrico, Quito-Ecuador

Mónica Moreno Castro, Hospital Metropolitano

UCI - Pediátrico. Quito-Ecuador

Citas

Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics 1957; 19: 823–832

Burgunder L. Fluids and Electrolytes. En: Kleinman K, The Harriet Lane Handbook, 22nd edition, p. 261

Campos-Miño S, Yerovi R. Tratamiento nutricional del Niño en Ventilación Mecánica. En: De Carvalho WB, Jiménez HJ, Sasbón JS, Carrillo H, Ventilación Pulmonar Mecánica en Pediatría. Atheneu, San Paulo, 2012, p. 469 – 488.

Talbot FB. Basal metabolism standards for children. Am J Dis Child 1938; 55: 455–459

Moritz ML. Maintenance Intravenous Fluids in Acutely Ill Patients. N Eng J Med 2105; 373: 1350-1360

Feld LG. Clinical Practice Guideline: Maintenance Intravenous Fluids in Children. Pediatrics 2018; 142 (6): e20183083

McNab S. Isotonic vs hypotonic intravenous fluids for hospitalized children. JAMA 2015; 314: 720–721

http://www.rxkinetics.com/ivosmolarity.html

Almeida HI, Mascarenhas MI, Loureiro HC. The effect of NaCl 0.9% and NaCl 0.45% on sodium, chloride, and acid-base balance in a PICU population. J Pediatr (Rio J) 2015; 91: 499–505

Friedman JN, Beck CE, DeGroot J. Comparison of isotonic and hypotonic intravenous maintenance fluids: a randomized clinical trial. JAMA Pediatr 2015; 169: 445–451

McNab S, Ware RS, Neville KA. Isotonic versus hypotonic solutions for maintenance intravenous fluid administration in children. Cochrane Database Syst Rev 2014; 12:CD009457

National Clinical Guideline Centre (UK). IV Fluids in Children: Intravenous Fluid Therapy in Children and Young People in Hospital. London, United Kingdom: National Clinical Guideline Centre; 2015. Available at: www.ncbi.nlm.nih.gov/pubmed/26741016

McNab S, Duke T, South M. 140 mmol/L of sodium versus 77 mmol/L of sodium in maintenance intravenous fluid therapy for children in hospital (PIMS): a randomised controlled double-blind trial. Lancet 2015; 385: 1190–1197

Carandang F, Anglemyer A, Longhurst CA. Association between maintenance fluid tonicity and hospital-acquired hyponatremia. J Pediatr 2013; 163: 1646–1651

Upadhyay A, Jaber BL, Madias NE. Incidence and prevalence of hyponatremia. Am J Med 2006; 119 (7, suppl 1): S30–S35

Moritz ML, Ayus JC. Disorders of water metabolism in children: hyponatremia and hypernatremia. Pediatr Rev 2002; 23: 371–380

Gerigk M, Gnehm HE, Rascher W. Arginine vasopressin and renin in acutely ill children: implication for fluid therapy. Acta Paediatr 1996; 85(5): 550–553

Judd BA, Haycock GB, Dalton RN, Chantler C. Antidiuretic hormone following surgery in children. Acta Paediatr Scand 1990; 79(4): 461–466

Arikan AA. Fluid overload is associated with impaired oxygenation and morbidity in critically ill children. Pediatr Crit Care Med 2012; 13: 253-258

Shaw AD. Major complications, mortality, and resource utilization after open abdominal surgery: 0.9% saline compared to Plasma-Lyte. Ann Surg 2012; 255: 821-829

Yunos NM. Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults. JAMA 2012; 308:1566-1572

Yunos NM. The biochemical effects of restricting chloride-rich fluids in intensive care. Crit Care Med 2011; 39: 2419-2424

Carcillo JA, Davis AL, Zaritzky A. Role of early fluid resuscitation in pediatric septic shock. JAMA 1991; 266: 1242-1245

Dellinger RP. Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012. Crit Care Med 2013; 41: 580-637

Maitland K. Mortlity After Fluid Bolus in African Children with Severe Infection. N Eng J Med 2011; 364: 2483-2495

Weiss SL. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Pediatr Crit Care Med 2020. DOI: 10.1097/PCC.0000000000002198

Russell MJ. Is There an Optimum Duration of Fluid Bolus in Pediatric Septic Shock? A Critical Appraisal of "Fluid Bolus Over 15-20 Versus 5-10 Minutes Each in the First Hour of Resuscitation in Children With Septic Shock: A Randomized Controlled Trial" by Sankar et al. Pediatr Crit Care Med 2018; 19: e435-e445

Sankar J. Fluid Bolus Over 15-20 Versus 5-10 Minutes Each in the First Hour of Resuscitation in Children With Septic Shock: A Randomized Controlled Trial. Pediatr Crit Care Med 2017; 18: e435-e445

Silversides JA. Liberal versus restrictive fluid therapy in critically ill patients. Intensive Care Med 2019; 45: 1440-1442

Long E. Cardiac Index Changes With Fluid Bolus Therapy in Children With Sepsis-An Observational Study. Pediatric Crit Care Med 2018; 513-518

Sinitski L. Fluid overload at 48 hours is associated with respiratory morbidity but not mortality in a general PICU: retrospective cohort study. Pediatr Crit Care Med 2015; 16: 205-209

Lex DJ. Fluid Overload Is Associated With Higher Mortality and Morbidity in Pediatric Patients Undergoing Cardiac Surgery. Pediatr Crit Care Med 2016; 17: 307-314

Ingelse SA. Early Fluid Overload Prolongs Mechanical Ventilation in Children With Viral-Lower Respiratory Tract Disease. Pediatr Crit Care Med 2017; 18: e106-e111

Goldstein SL, Currier H, Graf JM, Cosio CC, Brewer ED, Sachdeva R. Outcome in children receiving continuous venovenous hemofiltration. Pediatrics (2001) 107:1309–12. doi: 10.1542/peds.107.6.1309

Raina R. Fluid Overload in Critically Ill Children. Frontiers in Pediatrics 2018; 6: 306. DOI=10.3389/fped.2018.00306

Neyra JA. Association of Hyperchloremia With Hospital Mortality in Critically Ill Septic Patients. Crit Care Med 2015; 43: 1938-1943

Emrath ET. Resuscitation With Balanced Fluids Is Associated With Improved Survival in Pediatric Severe Sepsis. Crit Care Med 2017; 45: 1177-1183

Jansen E. Early lactate-guided therapy in intensive care unit patients: a multicenter, open-label, randomized controlled trial. Am J Respir Crit Care Med 2010; 182: 752-761

Descargas

Publicado

2020-10-29

Cómo citar

Campos Miño, S., & Moreno Castro, M. (2020). Fluidoterapia y electrolitos parenterales en pediatría. Metro Ciencia, 28(4), 4–15. https://doi.org/10.47464/MetroCiencia/vol28/4/2020/4-15

Número

Sección

Revisión de literatura

Artículos más leídos del mismo autor/a