roÁi loaÏn nÖÔÙc ÑieÄn giaÛi
DESCRIPTION
ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI. PGS.TS. BUØI QUOÁC THAÉNG Phoù Tröôûng boä moân HSCCCÑ Ñaïi hoïc Y döôïc TPHCM. NHU CAÀU NÖÔÙC ÑIEÄN GIAÛI. NHU CAÀU NÖÔÙC ÑIEÄN GIAÛI. 1700 ml. NHU CAÀU NÖÔÙC ÑIEÄN GIAÛI. Na : 135 – 145 mEq Ngoaïi baøo K: 150 mEq Noäi baøo Moãi 100 ml nöôùc : - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/1.jpg)
ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI
PGS.TS. BUØI QUOÁC THAÉNG
Phoù Tröôûng boä moân HSCCCÑ
Ñaïi hoïc Y döôïc TPHCM
![Page 2: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/2.jpg)
NHU CAÀU NÖÔÙC ÑIEÄN GIAÛI
Caân naëng Nhu caàu
dòch/ngaøy
Toång dòch
10 kg ñaàu 100 ml/kg 1000
10 kg tieáp 50 ml/kg 500
Kg tieáp theo 20 ml/kg
![Page 3: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/3.jpg)
NHU CAÀU NÖÔÙC ÑIEÄN GIAÛI
Caân naëng Nhu caàu Toång dòch
10 kg ñaàu 100 ml/kg 1000
10 kg tieáp 50 ml/kg 500
10 kg cuoái 20 ml/kg 200
1700 ml
![Page 4: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/4.jpg)
NHU CAÀU NÖÔÙC ÑIEÄN GIAÛI
Na : 135 – 145 mEq Ngoaïi baøo
K : 150 mEq Noäi baøo
Moãi 100 ml nöôùc :
– Na : 3 mEq
– K : 2 mEq
– Ca : 0,5 – 1 mEq
![Page 5: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/5.jpg)
CAÙC LOAÏI DÒCH (1000 ml)
Glucose : 50g
NS : 9g Na+: 154 Cl- : 154
Dextrose Saline :– Dextrose : 50 g
– NaCl : 9 g
Dextrose ½ Saline:– Dextrose : 50 g
– NaCl : 4,5 g
Dextrose ¼ Saline:– Dextrose : 50 g
– NaCl : 2,25 g
![Page 6: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/6.jpg)
CAÙC LOAÏI DÒCH
Loaïi dòch Aùp löïc
thaåm
thaáu
Glucose NaCl Na
(mEq)
Cl
(mEq)
Glucose
5%275 50
Normal
Saline308 9 154 154
Dextrose -
Saline
Öu
tröông50 9 154 154
Dextrose –
½ Saline
Öu
tröông50 4,5 77 77
Dextrose –
¼ Saline
Öu
tröông50 2,25 38,5 38,5
![Page 7: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/7.jpg)
HES : Hydroxy Ethyl Starch
Chaát keo duøng nhieàu nôi nhö chaát TTHT
Ñöôïc taïo thaønh töø amilopectin cuûa tinh
boät
TLPT trung bình laø 450.000 vaø 90% laø caùc
phaân töû 10.000 – 1.000.000
TLPT > D70 nhöng trong ñieàu trò soác giaûm
theå tích keát quaû so vôùi D70 cuõng nhö nhau
Tieâm truyeàn HES vaøo ngöôøi TTHT 110%
Phaân boá vaø baøi tieát HES vaø D70 nhö nhau
![Page 8: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/8.jpg)
HES : Hydroxy Ethyl Starch
Lôïi ñieåm cuûa HES so vôùi D70 laø HES ít coù
phaûn öùng mieãn dòch vaø ít tai bieán maãn
caûm
HES naèm trong noäi maïch laâu hôn D70 vaø
taêng TTHT hôn D70
Hieän taïi HES coù TLPT 30.000-40.000 ñöôïc
söû duïng ôû Nhaät vaø nghieân cöùu söû
duïng ôû Myõ
Trình baøy döôùi chai 500ml dd 6% trong NaCl
0.9%
![Page 9: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/9.jpg)
HES : Hydroxy Ethyl Starch
HES 6% / 200 / 0,5
Nồng độ
Trọng lượng phân tử
Độ thay thế
![Page 10: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/10.jpg)
HES
![Page 11: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/11.jpg)
HES : Noàng ñoä
Caøng cao thì ñoä nhôùt maùu caøng
taêng
HC di chuyeån chaäm
Töôùi maùu khoâng toát
Hieän coù 6% - 10%
![Page 12: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/12.jpg)
HES : troïng löôïng phaân töû
Caøng cao thì aùp löïc keo caøng lôùn
Voleùmie taêng nhanh vaø maïnh
Thöôøng laø loaïi 200.000
Neáu laø 130.000 thì taùc duïng gioáng
Gela.
Coù loaïi 170.000 (Voluven)
![Page 13: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/13.jpg)
HES : ñoä thay theá
Starch : tinh boät
HydroxyEthyl : OH – C2H5
Coù trong tinh boät (khoai taây, boät baép…)
Amylase caét nhanh
Duøng OH – C2H5 nhaân taïo gaén vaøo
tinh boät ñeå traùnh hieän töôïng naøy 10 gaén 5 0,5
100 gaén 42 0,42
![Page 14: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/14.jpg)
HES : kieåu thay theá
Tinh boät laø 1 chuoãi glucose C6H12O6
OH – C2H5 seõ gaén vaøo C2 hoaëc C6
Tæ leä gaén C2/C6 seõ quyeát ñònh söï toàn
taïi cuûa HES trong loøng maïch
Neáu gaén C2 nhieàu thì amylase khoâng
caét noåi toàn taïi trong loøng maïch laâu duy trì p keo toát.
![Page 15: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/15.jpg)
HES : kieåu thay theá
Hieän taïi C2/ C6 laø 6/1 (Tetraspan) hoaëc
9/1 (Voluven).
![Page 16: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/16.jpg)
HES : dung moâi
DD keo caân baèng : dung moâi Thaønh phaàn ñieän giaûi gioáng huyeát töông
Caùc chaát ñeäm taïo ra bicarbonate coù theå ñöôïc chuyeån hoaù taïi gan hoaëc cô
Coù HES duøng dung moâi laø NaCl 0,9% Coù theå duøng trong SXH vì Na vaø Clo
thöôøng giaûm
Trong caùc beänh lyù khaùc coù theå laøm taêng Na vaø Clo
![Page 17: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/17.jpg)
HES : suy thaän
Seõ ñöôïc amylase caét nhoû daàn, TLPT nhoû hôn 40.000 vaø ñöôïc thaûi qua thaän.
Khoâng laøm taêng ñöôøng huyeát do caét daàn
HES 10%/200 Phuø phoåi
Suy thaän
Phuø phoåi taïi N7 – N8 CPAP (thôû maùy) caøi PEEP cao Vieâm phoåi töû vong.
![Page 18: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/18.jpg)
HES
![Page 19: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/19.jpg)
CAÙC LOAÏI MAÁT NÖÔÙC
Na H2O
ÑAÚNG
NHÖÔÏC
ÖU
![Page 20: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/20.jpg)
MAÁT NÖÔÙC ÑAÚNG TRÖÔNG
![Page 21: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/21.jpg)
MAÁT NÖÔÙC ÑAÚNG TRÖÔNG
Treû 15 thaùng, 10kg
Tieâu chaûy N4, hieän 9 kg maát
nöôùc 10%
Ion ñoà : Na 140 mEq
![Page 22: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/22.jpg)
MAÁT NÖÔÙC ÑAÚNG TRÖÔNG
Na H2O
Nöôùc coù ñieän giaûi
![Page 23: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/23.jpg)
MAÁT NÖÔÙC ÑAÚNG TRÖÔNG
nöôùc Na+
K+
Nhu caàu 1000 ml 30 20
Nöôùc maát 1000 ml
ngoaïi baøo 600 ml 84
noäi baøo 400 ml 60
2000 ml 114 80
![Page 24: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/24.jpg)
MAÁT NÖÔÙC ÑAÚNG TRÖÔNG
Na ngoaïi baøo : 1000 ml 140
mEq
600 ml 84 mEq
Kali noäi baøo 1000 ml 150 mEq
400 ml 60 mEq
![Page 25: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/25.jpg)
LÖU YÙ
8g ñaàu :
– ½ löôïng nöôùc maát
– 1/3 löôïng nhu caàu
16g tieáp :
– ½ löôïng nöôùc maát
– 2/3 löôïng nhu caàu
![Page 26: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/26.jpg)
MAÁT NÖÔÙC NHÖÔÏC TRÖÔNG
![Page 27: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/27.jpg)
MAÁT NÖÔÙC NHÖÔÏC TRÖÔNG
Treû 15 thaùng, 10kg
Tieâu chaûy N4, hieän 9 kg maát
nöôùc 10%
Ion ñoà : Na 120 mEq
![Page 28: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/28.jpg)
MAÁT NÖÔÙC NHÖÔÏC TRÖÔNG
Na H2O
Nöôùc coù ñieän giaûi
Na
![Page 29: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/29.jpg)
MAÁT NÖÔÙC NHÖÔÏC TRÖÔNG
nöôùc Na+ K+
Nhu caàu 1000 ml 30 20
Nöôùc maát 1000 ml
ngoaïi baøo 600 ml 84
noäi baøo 400 ml 60
Na thieáu 90
2000 ml 204 80
![Page 30: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/30.jpg)
MAÁT NÖÔÙC NHÖÔÏC TRÖÔNG
Na ngoaïi baøo : 1000 ml 140
mEq
600 ml 84 mEq
Kali noäi baøo 1000 ml 150 mEq
400 ml 60 mEq
Na thieáu 0,6 x 10 x (135 – 120) = 90 mEq
![Page 31: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/31.jpg)
LÖU YÙ
GIOÁNG MAÁT NÖÔÙC ÑAÚNG
TRÖÔNG
8g ñaàu :
– ½ löôïng nöôùc maát
– 1/3 löôïng nhu caàu
16g tieáp :
– ½ löôïng nöôùc maát
– 2/3 löôïng nhu caàu
![Page 32: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/32.jpg)
MAÁT NÖÔÙC ÖU TRÖÔNG
![Page 33: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/33.jpg)
MAÁT NÖÔÙC ÖU TRÖÔNG
Treû 15 thaùng, 10kg
Tieâu chaûy N4, hieän 9 kg maát
nöôùc 10%
Ion ñoà : Na 165 mEq
![Page 34: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/34.jpg)
MAÁT NÖÔÙC ÖU TRÖÔNG
Na H2O
Nöôùc khoâng ñieän giaûi
(Free Water : FW)
Nöôùc coù ñieän giaûi
![Page 35: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/35.jpg)
MAÁT NÖÔÙC ÖU TRÖÔNG
nöôùc Na+ K+
Nhu caàu 1000 ml 30 20
Nöôùc maát 1000 ml
FW 600 ml
nöôùc coù ñieän giaûi 400 ml
ngoaïi baøo 240 ml 34
noäi baøo 160 ml 24
2000 ml 64 44
![Page 36: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/36.jpg)
MAÁT NÖÔÙC ÖU TRÖÔNG
FW 4 x 10 x (165 – 150) = 600 ml
Na ngoaïi baøo : 1000 ml 140
mEq
240 ml 34 mEq
Kali noäi baøo 1000 ml 150 mEq
160 ml 24 mEq
![Page 37: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/37.jpg)
LÖU YÙ (MAÁT NÖÔÙC ÖU TRÖÔNG )
Ñeå giaûm 1 mEq Na, caàn
– 4 ml/kg nöôùc neáu Na < 170 mEq
– 3 ml/kg nöôùc neáu Na ≥ 170 mEq
Chæ buø ½ löôïng nöôùc maát
Toång dòch seõ truyeàn trong 24 giôø
![Page 38: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/38.jpg)
BUØ NÖÔÙC ÑIEÄN GIAÛI
THEO KAPLAN
![Page 39: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/39.jpg)
XÖÛ TRÍ
Kaplan medical:
80-100
Na MAÙU
> 150 mEq/l
130-150 120-130 < 120
Noàng ñoä Na trong dung dòch thay theá
30-40 mEq/l
50-60 70-80
0,2% NS/D5%
Na =34 mEq/l
0,33% NS
Na=56
0,45% NS
Na =77
0,45% NS+ NaHCO3
Na= 100
![Page 40: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/40.jpg)
CAÙCH PHA DÒCH
D5% Dextrosaline dòch
1 1 ½ (Na = 77)
2 1 1/3 (Na = 56)
3 1 ¼ (Na = 34)
![Page 41: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/41.jpg)
TAÊNG Kali maùu
![Page 42: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/42.jpg)
ÑÒNH NGHÓA
Khi K+ > 5,5 mEq/L
(Textbook of Pediatric Emergency
Medicine, 4th – 2000 : 820 – 822)
![Page 43: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/43.jpg)
K+ = 6,0 – 7,0 : Taêng thaûi Kali
Theo doõi thöôøng xuyeân
– Kayexalate 1 – 2 g/kg + 3ml/kg Sorbitol 70% (U)
– Kayexalate 1 – 2 g/kg + 10 ml/kg nöôùc (HM)
– Kayexalate 1 – 2 g/kg + 4 - 8 ml/kg G10% (HM)
moãi 4 – 6 giôø
Ion ñoà moãi 6 giôø
Monitor nhòp tim
![Page 44: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/44.jpg)
K+ > 7,0 : Daãn Kali vaøo teá baøo
Glucose 25% : 2 ml/kg (G30% - G50%)
Insuline : 0,1 UI/kg
TMC > 30 phuùt
Coù theå laäp laïi sau 30 – 60 phuùt
Hoaëc TTM Glucose 25% 1 – 2 ml/kg/giôø
Insuline 0,1 UI/kg/giôø
![Page 45: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/45.jpg)
K+ > 7,0 : Daãn K+ vaøo teá baøo
NaHCO3 7,5%:
1 – 2 mEq/kg TMC 5 – 10 phuùt
![Page 46: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/46.jpg)
K+ > 8,0 hoaëc ngöng tim : thay ñoåi tính thaám maøng
teá baøo
Calcium Gluconate 10% ( 1ml 0,45
mEq):
0,5 – 1 ml/kg TMC 3 – 5 phuùt
Coù theå laäp laïi sau 10 phuùt
![Page 47: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/47.jpg)
Thuoác Lieàu
löôïng
Toác ñoä
cho
Thgian
taùc
duïng
CaGluconate
10%0,5 ml/kg 3 – 5 ph
1 ph
30 – 60ph
NaHCO3 7,5%2 – 3
mEq/kg30 – 60ph
30ph
1 – 4giôø
Glucose 50%
Insuline
regular
5 – 6g
1 UITTM > 30ph
Kayerxalate 1g/kg
4ml G10%
Moãi 4 – 6
giôø
Uoáng hoaëc
thuït thaùo
![Page 48: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/48.jpg)
Giaûm Kali maùu
K+ < 2,5 mEq/L
![Page 49: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/49.jpg)
Giaûm Kali maùu
Khoâng coù coâng thöùc tính buø
K+
Buø baèng ñöôøng uoáng laø an
toaøn
Chæ truyeàn TM (phaûi coù nöôùc
tieåu)
![Page 50: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/50.jpg)
Giaûm Kali maùu : buø ñöôøng uoáng
Buø theo nhu caàu
Chuoái, cam, nöôùc chanh, nöôùc döøa
Thuoác : Kaleoride, Kalion,….
Pha trong nöôùc tröôùc khi uoáng
![Page 51: ROÁI LOAÏN NÖÔÙC ÑIEÄN GIAÛI](https://reader035.vdocuments.mx/reader035/viewer/2022062517/56813566550346895d9cce32/html5/thumbnails/51.jpg)
Giaûm Kali maùuBuø baèng ñöôøng TTM
Pha K+ trong dòch truyeàn : 20 – 80
mEq
TTM : 0,25 – 0,5 mEq/kg/giôø
KCl 10% : 1ml 1,3 mEq