儿童血容量缺失

最后审阅: 21 四月 2022
最后更新: 11 八月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在危险因素
  • 口渴
  • 毛细血管再充盈时间>3 秒
  • 皮肤弹性降低
  • 黏膜干燥
  • 异常精神状态或活动水平
  • 心动过速
  • 尿量异常
  • 呼吸频率升高或呼吸深度增加
更多 关键诊断因素

其他诊断因素

  • 呕吐
  • 腹泻
  • 腹痛
  • 葡萄糖试纸条检测结果异常
  • 体核温度下降或发热
  • 血压异常
  • 瘀伤或被忽视的体征
其他诊断因素

危险因素

  • 呕吐和/或腹泻
  • 年龄<3 岁
  • 外伤
  • 烧伤>10% 体表面积
  • 1 型糖尿病
  • 经口摄入不良病史
  • 剧烈和长期运动
  • 利尿药使用史
更多 危险因素

诊断性检查

首要检查

  • 临床诊断
更多 首要检查

需考虑的检查

  • 血清电解质
  • 血糖
  • 血清尿素/肌酐比值
  • 全血细胞计数 (FBC)
  • 尿液分析
  • 尿比重
  • 尿液渗透压
  • 尿液显微镜检查和培养
  • 血液培养
  • 动脉血气分析
  • 头部超声或 CT 扫描
  • 腹部超声检查或 CT 扫描
更多 需考虑的检查

治疗流程

急症处理

经肠丢失

出血丢失

经皮肤丢失

经肾丢失

脓毒性休克

过敏性休克

撰稿人

作者

Katherine Mason, MD, FAAP

Vice Chair of Education, Department of Pediatrics

Associate Professor of Pediatrics

Brown University

Hasbro Children's Hospital

RI

利益声明

KM declares that she has no competing interests.

Sarah Spencer Welsh, MD, FAAP

Medical Director

Pediatric Intensive Care Unit

Hasbro Children’s Hospital

Assistant Professor of Pediatrics

The Warren Alpert Medical School of Brown University

RI

利益声明

SW declares that she has no competing interests.

Patricia Poitevien, MD, MSc

Residency Program Director

Hasbro Children’s Hospital

Department of Pediatrics

Assistant Dean

Office of Diversity and Multicultural Affairs

Warren Alpert Medical School at Brown University

RI

利益声明

PP declares that she has no competing interests.

鸣谢

Dr Katherine Mason, Dr Sarah Welsh and Dr Pat Poitevien would like to gratefully acknowledge Dr Marla R. Carter, Dr Risha Moskalewicz, Dr Vincent J. Wang, Dr Naseem Sulayman, and Anne Stormorken, previous contributors to this topic.

利益声明

VJW is an author of a number of references cited in this topic. MC, RM, NS, and AS declare that they have no competing interests.

同行评议者

Jana A. Stockwell, MD, FAAP, FCCM

Assistant Professor of Pediatrics

Pediatric Critical Care Medicine

Emory University School of Medicine

Children's Healthcare of Atlanta

Atlanta

GA

利益声明

JAS declares that she has no competing interests.

Joe Brierley, MD

Consultant Paediatric & Neonatal Intensive Care Unit

Great Ormond St Hospital for Children

London

UK

利益声明

JB is an author of a reference cited in this monograph.

Amber E.R. Young, BSc, MB ChB, FRCA

Consultant Paediatric Anaesthetist

Department of Anaesthesia

Frenchay Hospital

Bristol

UK

利益声明

AERY declares that she has no competing interests.

Akash Deep, MD, FRCPCH

Director

Paediatric Intensive Care Unit

King’s College Hospital

London

UK

利益声明

AD declares that he has no competing interests.

  • 鉴别诊断

    • 脱水
    • 急性肾小球肾炎
    • 肾上腺皮质功能不全
    更多 鉴别诊断
  • 指南

    • 医院内儿童和年轻人的静脉补液治疗
    • 拯救脓毒症运动儿童指南
    更多 指南
  • 患者教育信息

    烧伤(轻度)

    儿童腹泻

    更多 患者教育信息
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