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Management of Fluid and Electrolyte Abnormalities in Children

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Core Concepts in the Disorders of Fluid, Electrolytes and Acid-Base Balance

Abstract

Unlike adult kidney function which maintains steady state by protecting against changing volume and composition of the extracellular fluid, the neonatal and younger infant kidney maintains a positive balance of many solutes to promote growth. Fluid spaces differ with age, and growth and organ maturation allow homeostasis despite apparent limitations of renal function.

Correction of fluid and electrolyte abnormalities is based on fluid space anatomy, water turnover rate, and composition of common losses during childhood. Rapid extracellular volume repletion and subsequent use of standard oral replacement solutions for rehydration is presented. Guidelines for clinical assessment of hydration and response are outlined. Mechanisms leading to electrolyte imbalance are described and specialized conditions (neonatal period oligoanuria; burns; pyloric stenosis; congenital chloride diarrhea; perioperative fluid therapy; homeostasis in malnourished infants; prematurity) where development or treatment of fluid–electrolyte abnormalities differ from that in adolescent or adult are briefly reviewed.

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Author information

Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, Children’s Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA

    John T. Herrin M.B.B.S., F.R.A.C.P.

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  1. John T. Herrin M.B.B.S., F.R.A.C.P.
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Correspondence to John T. Herrin M.B.B.S., F.R.A.C.P. .

Editor information

Editors and Affiliations

  1. Brigham and Women's Hospital, Harvard Medical School, VA Boston Healthcare System, Blackfan Circle 4, Boston, 02115, Massachusetts, USA

    David B. Mount

  2. Harvard Medical School, Renal Division, Brigham and Women's Hospital, Francis Street 75, Boston, 02115, Massachusetts, USA

    Mohamed H. Sayegh

  3. Harvard Medical School, Renal Division, Brigham and Women's Hospital, Francis Street 75, Boston, 02115, Massachusetts, USA

    Ajay K. Singh

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Herrin, J.T. (2013). Management of Fluid and Electrolyte Abnormalities in Children. In: Mount, D., Sayegh, M., Singh, A. (eds) Core Concepts in the Disorders of Fluid, Electrolytes and Acid-Base Balance. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-3770-3_5

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  • DOI: https://doi.org/10.1007/978-1-4614-3770-3_5

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  • Publisher Name: Springer, Boston, MA

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  • Online ISBN: 978-1-4614-3770-3

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