In Kaplan notes, it says that if the child is dehydrated with a Na concentration <120, you give 0.45%NaCl and D5W along with bicarb. Does it make any sense to make an already hyponatremic child even more hyponatremic by giving diluted NS????
YOU SEE THERE YOU ARE NOT GIVING PURE WATER . YOU ARE STILL GIVING NORMAL SALINE BUT IN LESS POWER THATS ALL. SO YOU ARE NOT GOING TO MAKE HIM MORE HYPONATREMIC . YOU ARE GOING TO CORRECT HYPONTREMIA BY GIVING O.45% NORMAL SALINE.
IT IS JUST LIKE THIS ANALOGY AS A ADULT YOU ARE HAVING DRY RICE AND THE CHILDRENN ARE TAKING SOFT RICE BUT BOTH WAY THEY ARE TAKING RICE. SUUPOSE YOU HAVE GOT LESS SUGAR IN THE BODY AND IF YOU TAKE SUGAR IN WATER OR DRY SUGAR WILL EAT MAKE MUCH DIFFERANCE,
YOUR QUESTION IS A GENUINE ONE . I KNOW WHAT ARE YOU ASKING BUT SOMETHING SHOULD BE UNDERSTOOD SIMPLY AS LONG AS YOU CAN UNDERSTAND.
ANSWER TO YOUR QUESTION HAS A BIOCHEMICAL BASIS BUT I GO WITH THIS PRACTICAL LOGIC.
BUT I HAVE NO OTER ARGUMENT HERE, DONT WANT TO DISCUSS ON IT.
THANKS . TAKE IT IF IT HELPS.
CHILD'S " KIDNEYS ARE NOT MATURE ENOUGH TO HANDLE HIGHER CONCENTRATION SODIUM SO WE ARE GIVING DILUTED SODIUM .
If that's true then why do you give 3% NaCl to a child with severe hyponatremia? (Also in the notes)
you have already answererd the question yourself. it is a severe hypontremia and you got to control it.
risk /benefit stretegy ---you need this stretegy in medical science in many times.