Anesteziyolojide Pediatrik İntraoperatif Sıvı Tedavisi

Yıl 2025, Cilt: 34 Sayı: 3, 213 - 228, 30.09.2025

Ersel Güleç

https://doi.org/10.17827/aktd.1667531

Öz

Pediatrik anestezi, çocukların farklı fizyolojik özellikleri nedeniyle sıvı ve elektrolit yönetiminin dikkatle değerlendirilmesini gerektirir. Doğum sonrası adaptasyonların bilinmesi, dehidrasyon veya aşırı hidrasyondan kaynaklanan komplikasyonların önlenmesinde kritik öneme sahiptir. Çocukların toplam vücut suyu yüzdesi daha yüksektir, bu da onları sıvı dengesizliklerine karşı daha savunmasız hale getirir. Hissedilmeyen kayıplar solunum hızına ve çevresel koşullara bağlıdır; aksi takdirde, kayıp derhal düzeltilmezse dehidrasyona neden olur. Yenidoğan böbrek fizyolojisi sıvıların filtrasyonunu ve elektrolitlerin yönetimini etkiler, bu nedenle yenidoğanlar için bireyselleştirilmiş sıvı tedavisi gerektirir. Hormonal kontrol, kapiller hidrodinamik, metabolik faktörler ve elektrolit dengesi pediatrik sıvı tedavisini daha da karmaşık hale getirir. Yüksek teknolojili monitörizasyon ve multimodal yöntemlerle desteklenen klinik değerlendirme ölçütleri, çocukların sıvı durumunun değerlendirilmesine yardımcı olacaktır. Son kılavuzlara göre pediatrik intravenöz sıvı tedavisi olarak yeterli elektrolit bileşimine sahip izotonik solüsyonlar kullanılmalıdır. Çoğu pediatrik hastanın başlangıç yönetiminde kristalloidler kolloidlere tercih edilir, ancak sıvı yönetimi her bir hasta faktörüne göre uyarlanmalı ve perioperatif dönem boyunca sürekli izlenmelidir.

Anahtar Kelimeler

Anestezi , Sıvı Tedavisi , İntravenöz İnfüzyonlar , Pediatri , Perioperatif Bakım.

Pediatric Intraoperative Fluid Therapy in Anesthesiology

Öz

Pediatric anesthesia requires careful consideration of fluid and electrolyte management due to the distinct physiological properties of children. Knowledge of postnatal adaptations is critical in avoiding complications from dehydration or overhydration. Children have a higher percentage of total body water, which makes them more vulnerable to imbalances in fluids. Insensible losses depend on respiratory rates and environmental conditions; otherwise, loss would result in dehydration if not corrected promptly. The neonatal renal physiology affects the filtration of fluids and the management of electrolytes, thus requiring individualized fluid therapy for neonates. Hormonal control, crossed capillary hydrodynamics, metabolic factors, and electrolyte equilibrium complicate pediatric fluid therapy further. Clinical evaluation measures aided by high-tech monitoring and multimodal methods will help assess children’s fluid status. Isotonic solutions with adequate electrolyte composition are to be used as pediatric intravenous fluid therapy according to the recent guidelines. Crystalloids are preferred over colloids in the initial management of most pediatric patients. Recent evidence supports the use of isotonic balanced crystalloids to minimize iatrogenic complications such as hyponatremia and hyperchloremic acidosis, with ongoing monitoring tailored to individual patient needs.

Anahtar Kelimeler

Anesthesia , Fluid Therapy , Intravenous Infusions , Pediatrics , Perioperative Care.

Destekleyen Kurum

This study did not receive any institutional or funding support.

Kaynakça

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