Gardajas disturbios eletroliticos[1] Central nervous manifestations of disordered sodium metabolism. N Engl J Med. Serum lactate and base deficit as predictors of mortality and morbidity. Implications for the pathogenesis of central pontie myelinolysis. Pathophysiology and treatment, a pediatric perspective.

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Objective: To review the major concepts involving electrolyte disorders in pediatrics, with special emphasis on the diagnosis and treatment.

Method: Systematic literature review, searching through classic pediatric textbooks, periodic electronic databases, such as Medline, Lilacs and other sources. Results: Electrolyte disorders are among the most common events in pediatric medical practice, specially in emergency care, where, depending upon the magnitude, they may represent significant risk to patient life or to the development of permanent sequelae.

Dehydration, independent of etiology, has its importance defined by the severity of water deficit mild, moderate or severe and by the proportion of sodium waste in relation to water deficit isotonic, hypotonic and hypertonic , and should be correctly recognized to guide adequate treatment. Sodium disorders have major risks of central nervous system compromise and potassium disorders are specially linked to cardiac arrhythmia, always deserving special attention and care.

On the other hand, calcium, phosphorus and magnesium disorders are more related to neuromuscular function alterations and, although less threatening, they need adequate recognition and management.

Conclusion: Knowledge of the several mechanisms involved in water and electrolyte metabolism is crucial to the correct comprehension, diagnosis and management of fluid and electrolyte disorders in pediatrics. Rio J. S S Jornal de Pediatria - Vol. Jornal de Pediatria - Vol. S Jornal de Pediatria - Vol. Drogas carbamazepina, morfina, vasopressina, etc.

Ansiedade dor, estresse Outras neoplasias, Addison, lupus, etc. As principais causas de hipopotassemia encontram-se discriminadas na Tabela ,18,20, Nos casos moderados e graves, segue-se o seguinte roteiro: 1.

As principais causas de hipercalcemia encontram-se relacionadas na Tabela ,26, Tabela 8 - Principais causas de hipercalcemia Jornal de Pediatria - Vol. As principais causas de hipo e hiperfosfatemia encontram-se discriminadas na Tabela Dell RB. In: Winters RW, ed. Barcelona: Elicien; McCarthy PL. General considerations in the care of sick children: parenteral fluid therapy.

Nelson textbook of Pediatrics. Philadelphia: WB Saunders; Harrison HE. Dehydration in infancy: hospital treatment. Pediatr Rev ; Kallen RJ. The management of diarrheal dehydration in infants using parenteral fluids. Pediatr Clin North Am ; The maintenance need for water in parenteral fluid therapy.

Pediatrics ; Estimation of parenteral fluid requirements. Pediatr Clin North Am ; Cardoso AL. Cavinatto JN. Renal and electrolyte emergencies. Textbook of pediatric emergency medicine. Pathophysiology of hyponatremia after transsphenoidal pituitary surgery. J Neurosurg ; Intranasal desmopressin-associated hyponatremia: a case report and literature review.

J Fam Pract ; Fatal child abuse by forced water intoxication. Pediatrics ; 6 Pt 1 Clinical interpretation of laboratory values. Fluid and electrolytes.

Hellerstein S. Fluid and electrolytes: clinical aspects. Norwalk: A Lange; Gruskin AB, Sarnaik A. Hyponatremia: Pathophysiology and treatment, a pediatric perspective. Pediatr Nephrol ;6: Manegement of hyponatremic seizures in children with hypertonic saline: A safe and effective strategy.

Crit Care Med ; Central myelinolysis and pontine lesion after rapid correction of hyponatremia. Ann Neurol ; Study of brain electrolytes and organic osmolytes during correction of chronic hyponatremia.

Implications for the pathogenesis of central pontie myelinolysis. J Clin Invest ; Conley SB. Fluid and electrolytes: physiology. Arieff AI. Central nervous manifestations of disordered sodium metabolism. J Clin Endocrinol Metab ; Brem AS. Disorders of potassium homeostasis. Hypokalemia in an asthmatic child from abuse of albuterol metered dose inhaler.

Pediatr Emerg Care ; Hypocalcemia in critically ill children. J Pediatr ; Bilezikian JP. Manegement of acute hypercalcemia. N Engl J Med ; Ionized magnesium concentrations in critically ill children.

Crit Care Med ; Intravenous correction of neonatal hypomagnesemia: effect on ionized magnesium.


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