How do you fix Hypernatremic dehydration in neonates?

How do you fix Hypernatremic dehydration in neonates?

If the cause is dehydration, restore circulating blood volume with 0.9% saline and then give 5% dextrose/0.3% to 0.45% saline solution IV in volumes equal to the calculated fluid deficit. Rehydrate over 2 to 3 days to avoid a too-rapid fall in serum sodium, which can have significant adverse consequences.

How do you correct Hypernatremic dehydration in children?

A simplified approach is to use 5% dextrose in 0.9% sodium chloride as the replacement fluid. The sodium is closely monitored, and the amount of sodium in the fluid is adjusted to maintain a slow correction (about <0.5 mEq/L/h, with a correction goal of 8 mEq/L over 24 hours).

What is Hypernatremic dehydration?

Hypernatremic dehydration is defined as serum sodium greater than 150 mEq/L (150 mmol/L). Despite elevated sodium concentrations, the child actually has total body sodium deficiency, but the water loss exceeds the sodium loss.

How do you calculate fluid deficit in Hypernatremic dehydration?

Water deficit (in L) = [(current Na level in mEq/L – 145 mEq/L)/145 mEq/L)] × 0.6 X weight (in kg) Water deficit (in L) = [1- (145 mEq/L ÷ current Na level in mEq/L)] × 0.6 × weight (in kg)

How do pediatrics fix hypernatremia?

In cases of hypernatremia caused by sodium overload, sodium-free intravenous fluid (eg, 5% dextrose in water) may be used, and a loop diuretic may be added. The serum sodium concentration should be monitored frequently to avoid too-rapid correction of hypernatremia.

What drugs cause hypernatremia?

Drug Induced Hypernatraemia

• Diuretics.
• Sodium bicarbonate.
• Sodium chloride.
• Corticosteroids.
• Anabolic steroids.
• Adrenocorticotrophic steroids.
• Androgens.
• Oestrogens.

What causes Hypernatremic dehydration?

Hypernatremia involves dehydration, which can have many causes, including not drinking enough fluids, diarrhea, kidney dysfunction, and diuretics. Mainly, people are thirsty, and if hypernatremia worsens, they may become confused or have muscle twitches and seizures. Blood tests are done to measure the sodium level.

How fast can you correct hypernatremia?

Chronic hypernatremia should be corrected at a rate of 0.5 mEq per L per hour, with a maximum change of 8 to 10 mEq per L in a 24-hour period.

What is a hypertonic IV solution?

Hypertonic Solutions. Hypertonic solutions have a higher concentration of dissolved particles than blood. An example of hypertonic IV solution is 3% Normal Saline (3% NaCl). When infused, hypertonic fluids cause an increased concentration of dissolved solutes in the intravascular space compared to the cells.

What are hypertonic IV solutions used for?

Examples of when hypertonic solutions are used include to replace electrolytes (as in hyponatremia), to treat hypotonic dehydration, and to treat certain types of shock. Solutions with a lower concentration of solutes than isotonic solutions are hypotonic.

Does dehydration cause hypernatremia?

Dehydration can cause hypernatremia (high levels of sodium ions in the blood) and is distinct from hypovolemia (loss of blood volume, particularly blood plasma).

What is hyponatremic dehydration?

Hyponatremic dehydration occurs when salt levels in the body drop. Sodium is one of the electrolytes found in the body. Its key role is to manage fluids and help the muscles and nerves function correctly.

What mechanism can cause hypernatremia?

Hypernatremia is usually caused by limited access to water or an impaired thirst mechanism, and less commonly by diabetes insipidus. Manifestations include confusion, neuromuscular excitability, hyperreflexia, seizures, and coma.

What IV fluids to give for hypernatremia?

Patients should be given intravenous 5% dextrose for acute hypernatremia or half-normal saline (0.45% sodium chloride) for chronic hypernatremia if unable to tolerate oral water.