Información adicional

• Num_publicacion 75(3-4)
• Resumen_ingles
  Introduction: Acute neurological complications during intravenous rehydration (IVR) of patients with hypernatremic dehydration (DH) relate to the rate of resulted decline in effective plasmatic osmolality (EPO) dependent of natremia, whose oscillations are directly related to the tonicity and/or infusion rate (IR) of used fluids. These two aspects differentiate the two types of existing IVR guidelines: conventional (CIR) and rapid (RIR). A comprehensive review of published experience on RIR and two previous theoretical analysis of maximum rates achieved in CIR and comparative risk linked to the pace of natremic decline in CIR versus RIR from scenarios of hypernatremic-DH, identified both optimized type of solution (glucose hydro-electrolytic-isotonic-isoclhorinated [GHEITIC]) and IR to propose to study.
  Objective: To evaluate the efficacy and safety of IVR of hypernatremic dehydrated patients with a GHEITIC solution (glucose 4.7%, sodium 132.7 mmol/L, chlorine 109 mmol/L, acetate 42.8 mmol/L, potasium 19.4 mmol/L) at a generic IR of 10 mL/kg/h (GHEITIC-10-IVR).
  Methodology: A prospective, experimental study: on 8 hypernatremic cases of 62 dehydrated patients (3 months-9 years) by digestive losses, treated by GHEITIC-10-IVR, were analyzed their clinical and laboratory course; main variable: natremia.
  Results: Most intense basal hyperchloremias and acidosis significantly correspond with hypernatremic cases and were corrected satisfactorily; their basal DH degree had been underestimated in all and they presented during GHEITIC-10-IVR a slow decrease in natremia (0.84 mmol/L/h), even incomplete in some, but all ended the correction orally. There was no end hyponatremia or significant ionic disturbances.
  Conclusions: The GHEITIC-10-IVR of hypernatremic dehydrated cases proves to be effective, safe and easy to run.
   
• Palabras_clave_ingles Hypernatremic dehydration Intravenous rehydration Glucose hydro electrolytic isotonic isochlorinated (GHEITIC) solution Infusion rate
• Todos_autores T. Jiménez Busselo, P. Calero Navarro, J. Aragó Domingo
• autores listados T. Jiménez Busselo, P. Calero Navarro, J. Aragó Domingo
• Correspondecia
  T. Jiménez Busselo. Servicio de Urgencias de Pediatría. Hospital Infantil Universitario «La Fe». Avda. Fernando Abril Martorell, 106. 46026 Valencia.
  Correo electrónico: jimenez_mai@gva.es
• Titulo_ingles Hypernatremic dehydration. Optimized intravenous rehydration: generic and secure
• Centros_trabajo Sección de Urgencias Pediátricas. Servicio de Pediatría. Hospital Universitario y Politécnico «La Fe». Valencia
• Publicado en Acta Pediatr Esp. 2017; 75(3-4): e28-e40
• copyright ©2017 Ediciones Mayo, S.A.
• Fecha recepcion 20/04/16
• Fecha aceptacion 13/06/16
• Tipo de Artículo Clínico (Microdatos) Observational Study