Pediatric fluid therapy

Liquid therapy is a common clinical treatment method in pediatrics, especially the preparation of mixed liquids is extremely common in the clinic, but the conventional preparation methods in textbooks are more complex, the composition of the liquid is not easy to remember, the simple preparation methods are 500ml for example, in addition to not accurate enough, the clinical application is not easy to implement, some physicians even have to copy the simple preparation methods in a small notebook, and then read when using, in the clinical application It is extremely inconvenient, especially in the emergency department and rescue emergency patients, and the need to prepare the special tension of the liquid appears to be more passive For this reason, the author according to their clinical experience, combined with relevant information, summarized the mixture of rapid formula for teaching and clinical reference. Zhang Jiankui, Department of Pediatrics, The First Affiliated Hospital of Henan College of Traditional Chinese Medicine1 Extrapolation process It is well known that the sodium-chloride ratio of plasma is 3:2, therefore, the mixture prepared into that ratio is most consistent with human physiology, which is the theoretical basis of the rapid calculation formula for the preparation of mixed liquids summarized by the author. The general mixture preparation follows the principle that the tension of the composition of the liquid is no-tension or equal-tension, commonly used no-tension liquid is 5% or 10% glucose, equal-tension sodium-containing liquid is 0.9% sodium chloride, 1.4% sodium bicarbonate, 1.87% sodium lactate, formulated generally with no-tension liquid and high-tension sodium-containing liquid, commonly used high-tension liquid is 10% sodium chloride, 5% sodium bicarbonate or 11.2% sodium lactate. In order to get a mixture of sodium to chloride ratio of 3:2, 2 parts of 0.9% sodium chloride and 1 part of 1.4% sodium bicarbonate or 1.87% sodium lactate are needed, i.e. the amount of 0.9% sodium chloride is 2/3 of the sodium equivalent, and the amount of 1.4% sodium bicarbonate or 1.87% sodium lactate is 1/3 of the sodium equivalent. therefore: the amount of sodium equivalent = total mixture × tension, so 0.9% According to “C dilute × V dilute = C concentrated × V concentrated”, the amount of 10% sodium chloride = total mixed liquid × tension × 2/3 × 0.9% ÷ 10% = total mixed liquid × tension × 6% Similarly, the amount of 1.4% sodium bicarbonate = total mixed liquid × tension × 1/3 According to “C dilute × V dilute = C concentrated × V concentrated”, the amount of 5% sodium bicarbonate = total mixture × tension × 1/3 × 1.4% ÷ 5% ≈ total mixture × tension × 9.3%. And so on, 11.2% sodium lactate ≈ total mixed liquid × tension × 6%. The remaining liquid is prepared with no Zhang liquid that is 5% or 10% glucose.2 Formulation formula Therefore, any sodium-chloride ratio of 3:2 mixture, can be prepared according to the following method: Formula 1: 10% sodium chloride liquid volume (ml) = total mixture × tension × 6% Formula 2: 5% sodium bicarbonate liquid volume (ml) = total mixture × tension × 9.3% or 11.2 sodium lactate liquid volume (ml ) = total mixture × tension × 6% Equation 3: 5% or 10% glucose liquid volume (ml) = total mixture – 10% sodium chloride liquid volume – 5% sodium bicarbonate or 11.2% sodium lactate liquid volume 3 Examples of preparation Example 1, the preparation of equal tension liquid (2:1 liquid) 200ml, the required 10% sodium chloride = 200 × 1 × 6% = 12ml, 5% sodium bicarbonate = 200 × 1 × 9.3%≈19ml, 10% dextrose=200-12-19=169ml; Example 2, to prepare 1/2 sheet containing sodium (:2:1 liquid) 300ml, 10% sodium chloride=300×1/2×6%=9ml, 11.2% sodium lactate=300×1/2×6%=9ml, 10% dextrose=300-9-9=282ml; Example 3, to prepare 2/3 sheet containing sodium (:2:1 liquid) 300ml, 10% sodium chloride=300×1/2×6%=9ml, 11.2% sodium lactate=300×1/2×6%=9ml, 10% dextrose=300-9-9=282ml Prepare 2/3 sheets of sodium-containing solution (4:3:2 liquid) 300ml, 10% sodium chloride required = 300×2/3×6%=12ml, 5% sodium bicarbonate = 300×2/3×9.3%=19ml, 10% glucose = 300-12-19=269ml; Example 4, prepare 1/3 sheets of sodium-containing solution (6:2:1 liquid) 300ml, 10% sodium chloride required = 300 × 1/3 × 6% = 6ml, 5% sodium bicarbonate = 300 × 1/3 × 9.3% ≈ 9ml, 10% dextrose = 300-6-9 = 285ml; Example 5, to prepare 1/5 sheet containing sodium solution 300ml, 10% sodium chloride = 300 × 1/5 × 6% = 3.6ml, 5% sodium bicarbonate = 300 × 1/5 × 9.3% ≈ 5.6ml The author believes that the formula is simple to calculate, easy to use, quick to calculate, accurate and practical, very much in line with human physiology, and can be used without memorizing its composition, if applied to simple preparation, plus easy, especially for the grassroots. The formula not only makes up for the lack of simple formula calculation in the preparation of mixed liquids, but also has clinical practical value, worthy of home application and promotion.