小儿科药物剂量专家讲座.pptx

PediatricDosage

小兒科藥物劑量三軍總醫院小兒部Instructor:R2王聖儒小儿科药物剂量第1页

Fulidsupplement0～10Kg(4MD/kg)：100ml/kg/day10～20kg(2MD/kg)：1000㏄＋(BW－10)×50㏄/day＞20kg(1MD/kg)：1500㏄＋(BW－20)×20㏄/dayExample1:BW=25kg,KeepIVroutewith0.33%G/S______MD/minAns:(10×4)+(10×2)+(5×1)=65MD/minExample2:BW=30kg,KeepIVroutewith0.33%G/S______MD/min______c.c.qdAns:(10×4)+(10×2)+(10×1)=70MD/min(10×100)+(10×50)+(10×20)=1700c.c./day小儿科药物剂量第2页

ManagementofDehydrationAccessfluiddeficit:5%(mild):Consolable,Drytongue,Mildlossofskinturgor5%-10%(moderate):Irritable,Reducedurineoutput,Deepseteyes,Tachypnea,Markedlossofskinturgor10%(severe):LethargyorComa,Sunkenanteriorfrontanelleandeyes,Coldextremities,Weakorimpalpablepulse,Hypotension小儿科药物剂量第3页

ManagementofDehydrationRehydration:First8hrLater16hrDeficit1/21/2Maintenance1/32/3e.g.:10kg,10%loss,≧3days?Deficit:10%x10(kg)x0.6(deficit%fromECF)X1000=600mlMaintenance:10x100=1000mlFirst8hrlater16hrDeficit300ml300mlMaintenance333ml660ml小儿科药物剂量第4页

ManagementofDehydrationShock:20ml/kgN/SorLactateRingersor10ml/kg5%albumin,blood,plasmaLoadingspeed:10ml/kg/hr,(2ml/kg/hrinCHF)小儿科药物剂量第5页

ElectrolytesupplementNa：3～4mEq/kg/day3%NaCl1ml=0.5mEq0.9%NaCl500ml=77mEqK：2～3mEq/kg/day15%KCl1ml＝2mEqCa：200~1000mg/kg/dayq8h-qd10%Cagluconate(100mg/1ml,1Amp＝10ml)NaHCO3：1mEq/kg(ifPH＜7.2)17mEq/20cc/amp小儿科药物剂量第6页

CorrectMetabolicAcidosisTachypnea(BE=PCO2–1.5x[HCO3]+8?2)BEHCO3Mild1017?ObservationModerate10-2017-8?SlowcorrectionSe