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2019, Número 2

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Acta Pediatr Mex 2019; 40 (2)


Tratamiento individualizado de la deshidratación hipernatrémica en el recién nacido

López-Candiani C

Idioma: Español
Referencias bibliográficas: 36
Paginas: 99-106
Archivo PDF: 486.43 Kb.


FRAGMENTO

ANTECEDENTES

La hipernatremia (sodio sérico 145 mEq/L) es un desequilibrio que, cuando es grave (160 mEq/L), puede causar alteraciones vasculares y neurológicas agudas, dejar secuelas graves o causar la muerte en recién nacidos. Se han descrito: trombosis del seno sagital superior, aórtica mesentérica, renal, iliaca, femoral, poplítea y arteria retinal; hemorragia parenquimatosa, gangrena distal, enterocolitis necrosante, hipertensión arterial pulmonar e insuficiencia cardiaca derecha. La patogénesis de las lesiones cerebrales se describió hace más de medio siglo, muchas secundarias a una corrección inadecuada. Oddie informa una incidencia de 7 x cada 100,000 nacidos vivos. Se trata, en sí, de un trastorno de la concentración relativa de sodio en el espacio extracelular, y no necesariamente de la cantidad de sodio corporal total que puede estar elevada o ser normal; puede asociarse con volumen de agua corporal normal, alto o bajo.


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