“Efectos de la deshidratación severa en neonato de 12 dìas de vida”

Abstract

Neonatal dehydration is a disease whose incidence seems to be increasing according to the reports; Presented a list of 5x1000 live newborns worldwide.

Hypernatremia should be suspected in these patients when there is inconsolable crying, exaggeration of muscle tone and reflexes, altered state of consciousness, and convulsions.

The present case deals with: female patient of 12 days of life, born and resident in Latacunga, Prenatal Antecedents: 1st gesta, not planned, 6 prenatal controls. Natural history: Product of the first pregnancy, born by cephalus vaginal vaginal at term, without complications, weight: 2570 gr, size 47 cm, head circumference: 33.5 cm, thoracic perimeter 33 cm APGAR 8-9. Postnatal Background: Elimination of meconium at the first day of life, exclusive breast, adequate psychomotor development. Patient is referred to the Latacunga Type C Health Center for signs of dehydration. Father refers to poor diet 3 days before admission, drowsiness, rejection of shots and hyporeactivity confirming his / her picture is valued by treating doctor evaluates and decides his / her entrance to the area of Neonatology. Physical Exam: Weight 1810 gr. Size 47 cm. Cephalic Perimeter 33.7 cm. Chest perimeter 33.1cm. FC 157 X '. FR 58 x '. T °: 37.7 ° C, Sat: 98%, RT: 68 / 41mmHg. Dehydrated, afebrile, hyporeactive, depressed anterior fontanelle, sunken eyes, dry oral mucosa, positive fold sign, icteric facies, non-edemas extremities, BH, QS, Urea alteration 283.1 mg / dl, Creatinine 4.95 mg / dl, electrolytes (Sodium 170 mEq / L); Transfontanelar echocardiography that reported normal parameters and in renal ultrasonography that reflected changes in relation to acute nephropathy, chest X-ray evidenced signs of pneumonia. Diagnostic impression Severe hypernatremic dehydration; Neonatal pneumonia and Acute renal failure; Treatment Nasogastric tube feeding with formula milk; Control of vital signs; Control of ingestion-excreta; Intravenous hydration; Ceftriaxone, Oxaciclin; Nystatin, Imipenem during its evolution is requested without success, 15 days after completing the complete therapeutic scheme, it was decided to discharge it with weekly checks by the specialist doctor of the health unit mentioned.