Hypotonic dehydration Treatment

At first supplement the blood volume, in view of lacks the sodium to be more than the water scarcity the characteristic, uses is salt-bearing the solution or infiltrates the salt water vein drop note high, corrects the body fluid to infiltrate the condition and the supplement blood volume lowly.

1, mild and moderate lacks the sodium. According to clinical lacks the sodium degree to estimate needs to supply liquid quantity. For example, the body weight 60kg patient, the determination blood serum sodium is 135mmol/L, then estimated that each kilogram body weight loses sodium chloride 0.5g, altogether lacks sodium salt 30g. to be possible to supply half first generally, namely 15g, in addition sodium date required quantity 4.5g, altogether 19.5g, may approximately 2000ml complete through the vein drop note 5% glucose salt water. In addition, but should also give the date need liquid to measure 2000ml, and according to the water scarcity degree, increases some fluid infusion quantity suitably again. Other half's sodium, may supply in second date.

2, the specific weight lacks the sodium. To has the shock, should make up the blood volume first, improves the microcycle and the organization organ fills the class. The crystal fluid supplement amount used must be many, may give 5% sodium chloride solution 200~300ml first, corrects the blood sodium to be excessively low as soon as possible, restores the extracellular liquid volume and the osmotic pressure, causes the water to offset from dropsy's cell. Later will continue according to the condition to give infiltrates the salt water or the isotonic salt solution high again.

May generally the sodium salt quantity which needs to supplement according to the following formula computation:　　Must supplement the sodium salt measures (mmol) = [blood sodium normal value (mmol/L)- blood sodium to obtain value (mmol/L)] * body weight (kg) ×0.6 (female is 0.5).

For example body weight 50 kilograms feminine patient, obtains the blood sodium is 118, then must supplement sodium salt quantity = (142-118)×50×0.5=600mmol, according to 17mmol/Na+=1g sodium salt computation, then the 600mmol sodium approximately is the 35g sodium chloride. At the same day should supply must supplement that the sodium salt quantity half (17.5 g) and date required quantity (4.5g) total 22g, may lose to 3% sodium chloride solution first approximately 430ml, then supplies the isotonic salt solution approximately 1000ml. then to decide the blood serum sodium does again further treats when the reference observable.

3, lacks the sodium to be accompanied by the acidosis. After supplement blood volume and sodium salt, as a result of organism commutation adjustment function, acidosis Chang Ke obtains the correction, generally cannot use the alkalinity pharmacological treatment from the very beginning. If after the courage vigor assay determination, the acidosis completely had still not corrected time, but intravenous injection 1.25% sodium bicarbonate solution 100~200ml or balanced salty fluid 200ml, by the back sight situation decided again whether to continue the supplies. After the amount of urine achieves 40ml/h, should supplement the sylvite.