【正文】 Intravenous concentration% in the solute speed： 6~8h/d（ intravenous） Time： keep 4～ 6 day interdiction： directly intravenous， because heart stop！ Supplement potassium principle： Supplement Calcium and Magnesium Convulsion emerged ： 10% Calcium Gluconate 10ml+25% Glucose 10ml IV If convulsion hasn’t relieved after supplement calcium, ——give 25% ~be careful （ Calcium ） : ? HR80 time /minute ， stop！ ?Don’t leak out vessel ? Interval of the Digitalis ?Don’t injection with subcutaneous and intramuscular first fast then slow Principles of Therapy first thick then thin supplement potassium when having urine adjust any time and monitor Ongoing losses and daily requirement daily requirement 60~80ml/kg (1/3~1/5 tonicity) Ongoing losses follow the how much of the lost in the any time ( 1/2~1/3 tonicity) 12~24H equal the speed iv drip To continue the supplement potassium and correct acidosis The second day fluid infusion ： ? Neonate: to reduce the liquid and electrolytes properly. ? Severe malnutrition： to reduce the water amount properly, with low speed, 2/3~1/2 tonic supplement 10% GS and / or plasma Notes ? operation day 2 ml/kg/h ? the first day* 4 ml/kg/h —— (the first 10kg) 4 ml/kg/h —— (the second 10kg) 2 ml/kg/h *heart failure / breathing machine utilization: 3ml/kg/h put to open warm casing, the volume 10% Fluid requirement at post operation or heart failure heart failure or heart post operation ? Control the solution by intravascular injection ? Volume include : — maintenance fluid in vascular； — medicine and dilution； — rinse solution for the vascular tubule； — gastric tube or foodintake。 Fluid requirement at post operation ?Include potassium glucose and sodium 1/4~1/5 tension ? 10% GS 500ml ? 10%NaCl 10ml ? 10% KCl 15ml ? ( %GS、 %NaCl、 %KCl ) An 8 – month boy had diarrhea and vomited for 3 days, urine stream reduced, irritability. PE: Pulse rate 150/min, weight loss was 10%, blood pressure 65/40mmHg, skin color showed grey and skin turgor looked like tents. Mucous membranes were very dry。 eye ball was sunken greatly, anterior fontanel depressed greatly. Abdomen extended, bowel sound diminished. Answer question 2 How to administer the fluid therapy? The first day fluid infusion ： Dehydration Fluid replacement=losses (Accumulation + ongoing + daily ) Accumulation ongoing daily total amount (ml/Kg) mild 50 10~30 60~80 90~120 moderate 50~100 10~30 60~80 120~150 Severe 100~120 10~30 60~80 150~180 Accumulation: accumulation losses Ongoing: Ongoing losses daily: Physiological requirement Step 1： Plan supplementary fluid. ?First body weight is calculated by formula of growth and development section. ——(6+8 =8kg) ——2:1 sodium :20ml 8=160ml ——finished intravenously within 30min. Step 2： Acute loss ? be always isotonic dehydration, so we choose ： ——2:3:1 (2:glucose , 3: sodium, 1: % bicarbonate ) ——that belong to 1/2 tonicity. ——Repair of water and sodium deficits ● first 810 hours 810 ml/(kgh) ● half of total loss volume (160 8)ml/2=640 ml. Step 3.： 4:1 sodium ● be taken next 16 hours 5 ml/(kgh) ● 80 ml/kg 8kg=640 ml (another half) Step 4： Potassium supplement ? 8kg =? That means about 10% potassium chloride solution 32ml will be used by intravenous infusion. ? Notice supplement potassium ——when urine stream must be seen。 ——meanwhile, be aware of concentration(%) ——speed and time of it.