Question of the Week

Question :

Posted On : 06 Dec 2007

What amount of ringer lactate{RL} must be given to a seriously ill patient of dengue hemorrhagic fever? Does the RL causes any complications?

Expert Answer :

No expert answer available.

Answer Discussion :

skywalky

none that i know off

17 years ago

Dr. Rakesh Bhardwaj

20ml-kg repeated 3times in1 hr and later on till cvp is normal may be 100 150ml-kg . chf ,over hydration ,hypernatremia, seizures ,cerebral edema etc

17 years ago

g.kalyan

intial bolus of 20ml-kg follwed by 10 ml-kg,if shock is not corrected,start ionotropic support.normal saline is preferred over RL because to avoid lactic acidosis

17 years ago

pediatriconcall

RL is to be given as a bolus only when the child is in shock. The fluids to be continued are isotonic such as Normal saline. Fluids should be given starting at 4-6 ml-kg-hour in patients with hypovolemia and can be increased or decreased depending upon the clinical response. If fluid requirement exceeds more than 10 ml-kg-hour for more than 2 hours, then colloid infusion in form of dextran may be required. The child should be assessed every 1-2 hours to determine the next fluid rate. Inspite of fluid resuscitation and fall in hematocrit, if the child remains hemodynamically unstable, one must suspect a bleed and may consider blood transfusion. If the child does not seem to improving and is developing signs of pulmonary edema then ventilation and ionotropic support may be required. Once the patient improves, fluids must be gradually decreased and omitted to prevent fluid overload and congestive cardiac failure and pulmonary edema. Hypotonic fluids should be avoided as they tend to leak even more in the third spaces.• Urine output should be maintained at 0.5-1 ml-kg-hour

17 years ago

SHEELA

20cc-kg ok ok

17 years ago

Question of the Week

Home

Partner Sites