Hidratación parenteral con solución 90 (Solución Pizarro) en niños deshidratados por enfermedad diarreica

Abstract

RESUMEN: El objetivo de este estudio fue comprobar la seguridad y eficacia de la solución recomendada por Pizarro para el tratamiento parenteral de la deshidratación. Se hidrataron 50 niños con edad promedio de 10.3 ± 8.1 meses. De ellos 31 fueron hombres y 19 mujeres; 27 (54%) presentaban desnutrición y 45 (90%) habían recibido hidratación oral. Se programó la corrección del déficit con 25 ml/kg/hora. Se tomaron muestras de sangre para sodio, potasio, glicemia y gases arteriales al ingreso y cuando ya los niños estaban hidratados. Todos los niños se hidrataron sin complicaciones. Peso al ingreso: 6.63 ± 2.85 kg. Peso ganado: 5.18 ± 2.59%. Volumen de solución utilizado: 105.8 ± 45.8 ml/kg. Tiempo de hidratación: 4.32 ± 2.13 horas. Sodio al ingreso 139.32 ± 9.03 mmol/l. Sodio final: 137.1 ± 7.62 mmol/l. Potasio al ingreso: 4.10 ± 1.06 mmol/l. Potasio final: 4.22 ± 0.76 mmol/l. pH al ingreso: 7.25 :t 0.197. pH final: 7.34 :t 0.088. Glicemia al ingreso: 122.18 ± 66.31 mg/dl. Glicemia final: 117.46 ± 47 mg/dl. Se concluyó que la Solución de Pizarro es útil y segura para conseguir la hidratación de niños deshidratados por enfermedad diarreica cuando no se la puede alcanzar por vía oral.

ABSTRACT: Pizarro's solution for parenteral rehydration has the following composition in mmol/l: sodium: 90, potassium 20, chloride 80, acetate 30 and glucose 111. Fifty dehydrated infants were parenterally rehydrated with this solution in order to confirm its safety and efficacy. Mean age was 10.3± 8.1 months (SEM); 31 were males and 19 females; 27 (54%) were undernourished; 45 (90%) had previously received oral rehydration therapy. Pizarro's solution was intravenously administered at the rate of 25 ml/kg/hour. Blood samples for determination of sodium, potassium, glucose and blood gases were drawn at the beginning of therapy and after achieving rehydration. AII infants were rehydrated uneventfully. Initial weight was 6.63 ± 2.85 kg. Average weight gain was 5.18 ± 2.59%. The volume of fluid administered was 105.8± 45.8 ml/kg. Time to achieve rehydration was 4.32 ± 2.13 hours. Serum sodium levels were 139.32 ± 9.03 and 137.10 ± 7.62 mmol/l, serum potassium levels were 4.10 ± 1.06 and 4.22 ± 0.76 mmol/l, blood pH was 7.25 ± 0.197 and 7.34 ± 0.088, blood glucose levels were 122.18 ± 66.31 and 117.46 ± 47 mg/dl at admission and after rehydration, respectively. We concluded that Pizarro's solution is suitable and safe for intravenous rehydration of infants dehydrated by diarrheal disease when oral rehydration therapy is not feasible.