Hidratación parenteral en Pediatría. Cambios de paradigmas?

Autores/as

  • Ricardo Iramain

Palabras clave:

Fluido de mantenimiento, fluido parenteral, hiponatremia

Resumen

Los fluidos de mantenimiento intravenosos (IV) son diseñados para mantener la homeostasis cuando el paciente es incapaz de ingerir el agua requerida, electrolitos, y energía. La tradicional determinación de fluidos de volumen y su composición data del artículo de Hollyday y Segar del año 1957, el cuál describe la relación entre peso, gasto energético, pérdidas fisiológicas y niños sanos. Basados en estas estimaciones de requerimientos diarios de electrolitos, esta información apoya el uso de fluidos hipotónicos que fueron ampliamente usados en pediatría. Sin embargo el uso de los fluidos hipotónicos en pacientes hospitalizados quienes pueden tener desarreglos fisiológicos, menos gasto calórico, disminución del ritmo diurético, y elevados niveles de hormona antidiurética no constituye una alternativa óptima. Varios trabajos han demostrado en las 2 últimas décadas que las soluciones hipotónicas  pueden llevar a un aumento de la incidencia de hiponatremia. Está alteración electrolítica puede ser muy dañina y peligrosa para el organismo desde graves patologías neurológicas hasta la muerte. Esta revisión presenta la evidencia para el uso de fluidos isotónicos más que hipotónicos como solución intravenosa de mantenimiento.

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Publicado

2017-10-22

Cómo citar

Iramain, R. (2017). Hidratación parenteral en Pediatría. Cambios de paradigmas?. Pediatría (Asunción), 41(2), 143-149. Recuperado a partir de https://revistaspp.org/index.php/pediatria/article/view/134

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