Hidratación de mantenimiento en niños agudamente enfermos

Erdwis Pérez Pintado

Hidratación de mantenimiento en niños agudamente enfermos

Erdwis Pérez Pintado

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Introducción: un aspecto crítico del cuidado de pacientes agudamente enfermos es la administración de líquidos intravenosos. Existe poco consenso sobre la tasa más apropiada de administración y la composición de los líquidos intravenosos. La práctica con respecto a los fluidos de mantenimiento varía ampliamente.
Objetivo: describir la composición y las tasas de administración más apropiadas de los líquidos intravenosos.
Método: se realizó una revisión en Medline/Pubmed, Elseiver y Scielo de los artículos publicados en el período comprendido entre 1953-2016. No hubo restricción de idioma. Los términos de búsqueda fueron: fluidos intravenosos, hiponatremia y niños.
Desarrollo: los fluidos hipotónicos siguen siendo recomendados en pacientes agudamente enfermos, a pesar de la fuerte asociación entre su uso y el desarrollo de hiponatremia. La abrumadora evidencia prospectiva hasta la fecha, indica que las soluciones de mantenimiento isotónicas son más seguras que los fluidos hipotónicos en la protección de la hiponatremia moderada y severa.
Consideraciones finales: es hora de que dejemos de usar fluidos hipotónicos en estados de enfermedad asociados con exceso de arginina vasopresina, y no existe razón para que esta práctica continúe. Esta información debe ser difundida por la Academia, pues los profesionales involucrados en el cuidado de niños enfermos necesitan ser informados y entrenados adecuadamente.

Referencias

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