&

.
/


60%
( + )

35-37%

23% (10-30%)
14%
300 gr
20 gr ,
280 gr ,

3-5%

 &

3lt 4-5%
11lt 16%
3lt
1lt (,
, , ,
)

28 lt 40%


mEq/lt

Na

142

144

Ca

2,5

Mg

1,5

154

154

Cl

103

119

HCO3

27

30

PO4

SO4

16

154

154




K
Na
Mg
Cl
HCO3
PO4, SO4

mEq/lt
160
10
35
2
8
140
55




 



 Gamble
. 153 mEq/lt 153 mEq/lt

Cl- 103
Na+ 142
HCO3- 24
17
+ 4

Ca++ 5
Mg++ 2

11

 Gamble
Cl- ( )
(HCO3-, )

(, )


s



:
,

( )



 


!!"# $%
. =
. =
294 mosm/lt
.



&% !'(


. 40mmHg
20-30mmHg 2-5 mmHg =
10-15 mmHg 2


2
1%

294 mOsm/lt

: .,

ADH


: 160-180lt/24h
: 1-1.5lt (1%)
99% 2 (3 )
1 (
.)
.

2 ( .)
ADH 2

3
ADH 2

 2 &

(+, Ca++, Mg++)

 /



, , ,
, ,

;;;;


mEq/lt
)*'+*,
60
20
16
50

59
10
90
0-1
() 100
10
100
10
() 120
10
200
15-20

145
10
110
50
140
5
80
70

90 60-80
90
0-10

48
6
4
-

 /


Shock, , .

(),
()

, , , ,

4%
6-8%
10%

, , 

 2 &

Darrow Yannet

 Na
, ,
D/W 5% +


,
, ,

:, , ,
, , Ht
: 2 +

(mEq/lt) = 0.6


( D/W 5%)
ADH
,
(ADH),
( )
, , ,
, , ,
, ( <120mEq/lt)
,

: (Lasix, )

> 150 mEq/lt


 ./01
: ,
(. ),
( ),

-,
()

H2
.. 160 ( 10%)
10% ( 2 50 lt)
5 lt H2O



( NaCl)
( NaHCO3),
(NaHCO3 per os)
Na>154mEq/lt 2
-
2
Na
2 (D/W 5%)

: 3300 mEq (95%)

: 70 mEq
()
(3 mEq K 1 gr N)
(0.3 mEq K 1 gr /
.. : 3.5-5 mEq/lt (4)


3 mEq/lt

10%

()

 <3.5mEq/lt

, , ,

 <3.5mEq/lt

, , ,

KCl (1 gr 13,3 mEq K+)

K 3-3,5 200mEqK+
K <3 300-400 mEq K+
< 20 mEq/h, <150 mEq/24h

:
,
,
, ,
QRS,

>7.5 mEq/lt
< 7.5 mEq/lt

NaHCO3 +
+
D/W 10% + +


Ca IV