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CRITERIO PEDIÁTRICO

Acta Pediatr Mex.  THYaVHIYPS"! 

Tratamiento individualizado de la deshidratación


hipernatrémica en el recién nacido
Individualized treatment of hypernatremic dehydration in
newborn infant
Carlos López-Candiani

ANTECEDENTES

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3HOPWV]VSLTPHW\LKLZLYZLJ\UKHYPHH\UHWVY[LPUZ\ÄJPLU[LKLHN\H Neonatólogo, subdirector de Medicina


ƌşƟĐĂ͘
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TmZ MYLJ\LU[LZ KL OPWLYUH[YLTPH LZ SH KLZOPKYH[HJP}U HZVJPHKH JVU /ŶƐƟƚƵƚŽEĂĐŝŽŶĂůĚĞWĞĚŝĂƚƌşĂ͕ŝƵĚĂĚ
de México
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LU  3HZ JVTWSPJHJPVULZ L_[YHJLYLIYHSLZ KL SH KLZOPKYH[HJP}U Aceptado: 12 de febrero 2019

OPWLYUH[YtTPJHPUJS\`LUHSHPUZ\ÄJPLUJPHYLUHSHN\KHLSL]HJP}UKL Correspondencia
LUaPTHZOLWm[PJHZHJPKVZPZTL[HI}SPJHOPWVNS\JLTPHVOPWLYNS\JLTPH Carlos López Candiani
mensaje55@hotmail.com
`JVHN\SHJP}UPU[YH]HZJ\SHYKPZLTPUHKHLU[YLV[YHZ
ƐƚĞĂƌơĐƵůŽĚĞďĞĐŝƚĂƌƐĞĐŽŵŽ
,SVIQL[P]VKLLZ[LJYP[LYPVWLKPm[YPJVLZHWVY[HY\UTt[VKVKLJVYYLJJP}U López-Candiani C. Tratamiento in-
dividualizado de la deshidratación
KLZVKPV`HN\HPUKP]PK\HSPaHKVWHYHJHKHNYHKVKLKLZOPKYH[HJP}U` hipernatrémica en el recién nacido.
JVUJLU[YHJP}UZtYPJHKLZVKPVX\LL]P[LSHZJVTWSPJHJPVULZUL\YVS}- Acta Pediatr Mex. 2019;40(2):99-106.
K/͗ŚƩƉ͗ͬͬĚdž͘ĚŽŝ͘ŽƌŐͬϭϬ͘ϭϴϮϯϯͬWD-
NPJHZZLJ\UKHYPHZHSHJVYYLJJP}UYmWPKH 40No2pp99-1061782

www.actapediatrica.org.mx
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102
López Candiani C. Tratamiento de hipernatremia neonatal

C. Concentración de sodio D. Agua libre de una solución

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WYVWVYJP}UKLSxX\PKVX\LKLILZLYVZT}[PJH- ¶5HLUZVS\JP}U5HHJ[\HS
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$
Fórmula 2. *VUJLU[YHJP}UKLZVKPVLUSHZZVS\-
3HWYVWVYJP}UKLHN\HSPIYLKLLZ[HZVS\JP}UWHYH
JPVULZT,X3!
LSZVKPVZtYPJVLULSWHJPLU[L5LZKL"LZ
KLJPY KLSHZVS\JP}UZLYmHN\HSPIYL`LS
 ZLYmSxX\PKVVZTVSHYTLU[LHJ[P]V
Na sérico actual * 100 - porcentaje
de agua libre 7HYHLSWHJPLU[L5ZLKLZLHHKTPUPZ[YHY\UH[HZH
KLNS\JVZHHTNRNTPU:LKLILJHSJ\SHYJVU
100 IHZLLULSWLZVWYL]PVHSHKLZOPKYH[HJP}ULU
LSLQLTWSVZL\Z}LSWLZVHSUHJLYKLN
:\Z[P[\`LUKV! ,U[VUJLZZLT\S[PWSPJHUTNRNTPU
KLS KxH ` ZL VI[PLULU!  TN KL NS\JVZH
N:L\ZHKL_[YVZHHS NT3
170 * (100-15.5) = 143.6 mEq/L WHYHVI[LULYSVZNYHTVZKLJHYIVOPKYH[VZJHSJ\-
100 SHKVZWVYZPTWSLWYVWVYJP}UKPYLJ[H!T3KL
ZVS\JP}UKL_[YVZHHS 3HZPUKPJHJPVULZWHYH
LSWHJPLU[L5X\LKHYmUKLSHZPN\PLU[LMVYTH!
3VZ  T3 X\L ZL PUM\UKPYmU HS WHJPLU[L 5
KLILYmU [LULY \UH JVUJLU[YHJP}U KL ZVKPV KL
T,X3"KLLZ[HMVYTHYLJPIPYmT3 Dextrosa al 50% ………… 43.2 mL
KLHN\HSPIYL`LSZVKPVKLZJLUKLYmT,X3 NaCl 17.7% ………………35.9 mL
LUSHZZPN\PLU[LZO
Agua bidestilada ………… 670.9 mL

7VYYLNSHKLWYVWVYJPVULZZPZLKLZLHWYLWHYHY Total 750.0 mL,


ZVS\JPVULZJVU5HHT,X3WHYHT3 para 24 horas
ZLYLX\PLYLUT,XKLZVKPV:L\ZHZVKPV
JVUJLU[YHKVHS WHYHWYLWHYHYSHZZVS\JPV- (S[YHZJ\YYPYOVYHZKLILVI[LULYZL\UHU\L]H
ULZJVUZPKLYHUKVX\LT3KLZVS\JP}U[PLUL KL[LYTPUHJP}UKLZVKPVZtYPJV\UU\L]VWLZV
T,XKLZVKPVWVYSVX\LZL\[PSPaHYmU T3 `ZLYLHSPaHYmUSVZJmSJ\SVZU\L]HTLU[LJVUSVZ
WHYHVI[LULYSVZT,XKLZVKPVYLX\LYPKVZ KH[VZHJ[\HSLZ5VZLYLJVTPLUKHSHTLKPJP}U
WHYHSHZVS\JP}UKLOVYHZ KLZVKPV]HYPHZ]LJLZHSKxH

103
Acta Pediátrica de México 2019 marzo-abril;40(2)

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• :PKLZW\tZKLSH[VTHKLT\LZ[YHZHUN\x- KPS\PYLSZVKPVZtYPJVWVYZLYMYHUJHTLU[L
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• 5VKLILUWHZHYZLJHYNHZYmWPKHZJVUTmZ JVUJLU[YHJPVULZKLZVKPVZtYPJVUP[HTWVJV\U
KLT,X3KLKPMLYLUJPHWVYKLIHQVKLS [PLTWVKLJVYYLJJP}UHKLJ\HKVÄQVLU[VKVZSVZ
ZVKPVZtYPJV"LU[VKVJHZVZLJVUZPKLYHYmU JHZVZ,SHN\HSPIYL`WVYSV[HU[VSHJVUJLU[YH-
OPWVZTVSHYLZ`NLULYHYmYPLZNVKLLKLTH JP}UKLZVKPVKLWLUKLYmUKLSKtÄJP[KLHN\H
JLYLIYHS`JVU]\SZPVULZ(TH`VYKPMLYLU- KHKVX\LHMLJ[HSHWYVWVYJP}UKLHN\HJVYWVYHS
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[YtTPJHKLILZLYPUKP]PK\HSPaHKV
• 3HZ ZVS\JPVULZ HX\x JHSJ\SHKHZ ZVU
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T6ZT"5H2`*SZVUPUKLWLUKPLU[LZ
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HTNRNTPU HSV UVWHY[PJPWHYmUKLSHVZTVSHYPKHK
• :PZL\ZHSHZVS\JP}UNS\JVZHKHHSV  \UH]LaPUM\UKPKHZWVYX\LWLUL[YHHSHJtS\SH
WHYHSSLNHYHS]VS\TLUJHSJ\SHKVWHYHO JVUSHWtYKPKHKLZ\M\UJP}UVZT}[PJH`X\LKH
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NS\JVZHRNTPU\[V"SVTmZJVU]LUPLU[LLZ
JHSJ\SHYSHNS\JVZHKLZLHKHWHYHPUM\ZP}U Fórmula 4.6ZTVSHYPKHKZtYPJHT6ZT3!
`HKTPUPZ[YHYSHJVTVKL_[YVZHHS `
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KLILJVUZPKLYHYZLJVTVLSHN\HSPIYLKL 2.8 18

104
López Candiani C. Tratamiento de hipernatremia neonatal

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