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학습 자료 둘러보기 →Preventing Cerebral Edema During the First 24 Hours
In severe dehydration (>10% body weight loss), the brain generates idiogenic osmoles to maintain cell volume. Rapid IV fluid resuscitation lowers plasma osmolality, creating an osmotic gradient that pulls water into brain cells, risking cerebral edema. This mirrors the risk seen in DKA management.
Administer isotonic solutions (e.g., 0.9% NaCl) at a controlled rate. Avoid hypotonic fluids initially. Reassess after each bolus.
Check serum sodium levels frequently. A rapid rise or fall can indicate dangerous osmolar shifts. Target a gradual correction of 0.5-1 mEq/L/hr.
Immediately report any acute change in neurological status. Prepare for possible mannitol or hypertonic saline administration if cerebral edema is suspected.
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