{"id":22909,"date":"2023-04-17T18:23:24","date_gmt":"2023-04-17T11:23:24","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22909"},"modified":"2023-04-18T12:05:21","modified_gmt":"2023-04-18T05:05:21","slug":"che-do-dinh-duong-trong-dieu-tri-tre-em-nhiem-covid-19","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/che-do-dinh-duong-trong-dieu-tri-tre-em-nhiem-covid-19\/","title":{"rendered":"Ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng trong \u0111i\u1ec1u tr\u1ecb tr\u1ebb em nhi\u1ec5m COVID-19"},"content":{"rendered":"

Dinh d\u01b0\u1ee1ng<\/a> \u0111\u00f3ng vai tr\u00f2 r\u1ea5t quan tr\u1ecdng trong s\u1ef1 ph\u00e1t tri\u1ec3n to\u00e0n di\u1ec7n c\u1ee7a con ng\u01b0\u1eddi \u0111\u1eb7c bi\u1ec7t trong giai \u0111o\u1ea1n ph\u00e1t tri\u1ec3n c\u1ee7a tr\u1ebb em. Khi m\u1eafc b\u1ec7nh th\u00ec dinh d\u01b0\u1ee1ng c\u00e2n b\u1eb1ng v\u00e0 h\u1ee3p l\u00fd l\u1ea1i c\u00e0ng quan tr\u1ecdng h\u01a1n bao gi\u1edd h\u1ebft b\u1edfi n\u00f3 gi\u00fap c\u01a1 th\u1ec3 t\u0103ng c\u01b0\u1eddng h\u1ec7 mi\u1ec5n d\u1ecbch, n\u00e2ng cao th\u1ec3 tr\u1ea1ng v\u00e0 \u0111\u1ea9y l\u00f9i \u0111\u01b0\u1ee3c b\u1ec7nh t\u1eadt. Do s\u1ef1 b\u00f9ng n\u1ed5 c\u1ee7a \u0111\u1ea1i d\u1ecbch Covid 19 tr\u00ean to\u00e0n c\u1ea7u, tuy t\u1ef7 l\u1ec7 m\u1eafc \u1edf tr\u1ebb em ch\u01b0a cao nh\u01b0ng vi\u1ec7c \u0111\u01b0a ra h\u01b0\u1edbng d\u1eabn h\u1ed7 tr\u1ee3 dinh d\u01b0\u1ee1ng cho b\u1ec7nh nhi m\u1eafc vi\u00eam ph\u1ed5i c\u1ea5p l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 g\u00f3p ph\u1ea7n c\u1ea3i thi\u1ec7n k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb.<\/strong><\/p>\n

\"H\u1ed7
H\u1ed7 tr\u1ee3 dinh d\u01b0\u1ee1ng cho b\u1ec7nh nhi m\u1eafc COVID-19 l\u00e0 c\u1ea7n thi\u1ebft<\/figcaption><\/figure>\n

1. X\u00e1c \u0111\u1ecbnh nhu c\u1ea7u dinh d\u01b0\u1ee1ng c\u1ee7a tr\u1ebb<\/strong><\/h2>\n

1.1. Nhu c\u1ea7u n\u0103ng l\u01b0\u1ee3ng\u00a0<\/strong><\/h3>\n

– Nhu c\u1ea7u n\u0103ng l\u01b0\u1ee3ng khuy\u1ebfn c\u00e1o cho tr\u1ebb b\u1ec7nh kh\u00f4ng n\u1eb7ng \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y trong B\u1ea3ng 1.<\/p>\n

B\u1ea3ng 1. Nhu c\u1ea7u n\u0103ng l\u01b0\u1ee3ng cho tr\u1ebb em<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
Tu\u1ed5i<\/strong><\/td>\nNhu c\u1ea7u (kcal\/kg\/ng\u00e0y)<\/strong><\/td>\n<\/tr>\n
<3 th\u00e1ng<\/strong><\/td>\n110<\/td>\n<\/tr>\n
3-6 th\u00e1ng<\/strong><\/td>\n100-110<\/td>\n<\/tr>\n
>6 th\u00e1ng- 12 th\u00e1ng<\/strong><\/td>\n100<\/td>\n<\/tr>\n
1-3 tu\u1ed5i<\/strong><\/td>\n90-95<\/td>\n<\/tr>\n
3-6 tu\u1ed5i<\/strong><\/td>\n80-90<\/td>\n<\/tr>\n
6-9 tu\u1ed5i<\/strong><\/td>\n70-80<\/td>\n<\/tr>\n
9-12 tu\u1ed5i<\/strong><\/td>\n60-70<\/td>\n<\/tr>\n
12-15 tu\u1ed5i<\/strong><\/td>\n50-60<\/td>\n<\/tr>\n
15-18 tu\u1ed5i<\/strong><\/td>\n45-50<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

– Nhu c\u1ea7u n\u0103ng l\u01b0\u1ee3ng cho tr\u1ebb b\u1ec7nh n\u1eb7ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u1ea1i \u0111\u01a1n v\u1ecb h\u1ed3i s\u1ee9c PICU (Paediatric Intensive Care Units):<\/p>\n

Khuy\u1ebfn c\u00e1o x\u00e1c \u0111\u1ecbnh nhu c\u1ea7u n\u0103ng l\u01b0\u1ee3ng b\u1eb1ng m\u00e1y \u0111o nhi\u1ec7t l\u01b0\u1ee3ng gi\u00e1n ti\u1ebfp (IC- indirect calorimetry).<\/p>\n

N\u1ebfu kh\u00f4ng c\u00f3 thi\u1ebft b\u1ecb IC th\u00ec s\u1eed d\u1ee5ng c\u00f4ng th\u1ee9c t\u00ednh n\u0103ng l\u01b0\u1ee3ng c\u1ee7a Schofield<\/p>\n

B\u1ea3ng 2. C\u00f4ng th\u1ee9c Schofield x\u00e1c \u0111\u1ecbnh nhu c\u1ea7u n\u0103ng l\u01b0\u1ee3ng – (Kcal\/ng\u00e0y)<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n
Tu\u1ed5i (n\u0103m)<\/strong><\/td>\nGi\u1edbi<\/strong><\/td>\nC\u00f4ng th\u1ee9c theo c\u00e2n n\u1eb7ng<\/strong><\/td>\nC\u00f4ng th\u1ee9c theo c\u00e2n n\u1eb7ng v\u00e0 chi\u1ec1u cao<\/strong><\/td>\n<\/tr>\n
<3<\/strong><\/td>\ntrai<\/strong><\/td>\n59,48 W*<\/sup>-30,33<\/td>\n0,167W+1517,4H#<\/sup>-617,6<\/td>\n<\/tr>\n
g\u00e1i<\/strong><\/td>\n58,29 W-31,05<\/td>\n16,252W+1023,2H-413,5<\/td>\n<\/tr>\n
3-10<\/strong><\/td>\ntrai<\/strong><\/td>\n22,7W+505<\/td>\n19,59W + 130,3H+ 414,9<\/td>\n<\/tr>\n
g\u00e1i<\/strong><\/td>\n20,3W+486<\/td>\n16,97W + 161,8H+371,2<\/td>\n<\/tr>\n
10-18<\/strong><\/td>\ntrai<\/strong><\/td>\n17,7W+659<\/td>\n16,25W +137,2H+515,5<\/td>\n<\/tr>\n
g\u00e1i<\/strong><\/td>\n13,4W+696<\/td>\n8,365W+465H+200<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

*<\/strong>W: Weight- Tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3, d\u00f9ng c\u00e2n n\u1eb7ng th\u1ef1c t\u1ebf n\u1ebfu nh\u01b0 tr\u1ebb Suy dinh d\u01b0\u1ee1ng ho\u1eb7c th\u1eeba c\u00e2n- b\u00e9o ph\u00ec)<\/p>\n

#<\/strong>H: Height- Chi\u1ec1u cao<\/p>\n

1.2. Nhu c\u1ea7u n\u01b0\u1edbc, c\u00e1c ch\u1ea5t sinh n\u0103ng l\u01b0\u1ee3ng v\u00e0 \u0111i\u1ec7n gi\u1ea3i<\/strong><\/h3>\n

B\u1ea3ng 3. Nhu c\u1ea7u n\u01b0\u1edbc, c\u00e1c ch\u1ea5t sinh n\u0103ng l\u01b0\u1ee3ng v\u00e0 \u0111i\u1ec7n gi\u1ea3i<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
Th\u00e0nh ph\u1ea7n<\/strong><\/td>\nC\u00e2n n\u1eb7ng<\/strong><\/td>\n<\/tr>\n
< 10 kg<\/strong><\/td>\n10 – 20 kg<\/strong><\/td>\n>20 kg<\/strong><\/td>\n<\/tr>\n
D\u1ecbch (n\u01b0\u1edbc)<\/strong><\/td>\n100 – 150 ml\/kg<\/td>\n1000 ml + 50 ml\/kg (cho m\u1ed7i kg > 10 kg)<\/td>\n1500 ml + 20 ml\/kg (cho m\u1ed7i kg > 20 kg)<\/td>\n<\/tr>\n
Protid g\/kg<\/strong><\/td>\n1,5 – 3<\/td>\n1 – 2,5<\/td>\n0,8 – 2,0<\/td>\n<\/tr>\n
Glucid, g\/kg<\/strong><\/td>\n10 – 30<\/td>\n8 – 28<\/td>\n5 – 20<\/td>\n<\/tr>\n
Lipid, g\/kg<\/strong><\/td>\n0,5 – 4<\/td>\n1 – 3<\/td>\n1 – 3<\/td>\n<\/tr>\n
\u0110i\u1ec7n gi\u1ea3i<\/strong><\/td>\nTr\u1ebb s\u01a1 sinh<\/td>\nTr\u1ebb nh\u1ecf<\/td>\nTr\u1ebb v\u1ecb th\u00e0nh ni\u00ean<\/td>\n<\/tr>\n
Natri<\/strong><\/td>\n2 – 4 mEq\/kg<\/td>\n2 – 4 mEq\/kg<\/td>\n60 – 150 mEq<\/td>\n<\/tr>\n
Kali<\/strong><\/td>\n2 – 4 mEq\/kg<\/td>\n2 – 4 mEq\/kg<\/td>\n70 – 180 mEq<\/td>\n<\/tr>\n
Clo<\/strong><\/td>\n2 – 4 mEq\/kg<\/td>\n2 – 4 mEq\/kg<\/td>\n60 – 150 mEq<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Nhu c\u1ea7u c\u00e1c ch\u1ea5t kho\u00e1ng v\u00e0 vitamin theo khuy\u1ebfn ngh\u1ecb c\u1ee7a vi\u1ec7n Dinh d\u01b0\u1ee1ng n\u0103m 2016<\/p>\n

2. Ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng<\/b><\/h2>\n

– Hi\u1ec7n nay, s\u1ed1 li\u1ec7u v\u1ec1 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng c\u1ee7a tr\u1ebb COVID-19 c\u00f2n \u00edt, tuy nhi\u00ean \u1edf tr\u1ebb em th\u1ea5y bi\u1ec3u hi\u1ec7n b\u1ec7nh th\u01b0\u1eddng nh\u1eb9 h\u01a1n so v\u1edbi ng\u01b0\u1eddi l\u1edbn v\u00e0 c\u00e1c bi\u1ec3u hi\u1ec7n ch\u00ednh th\u01b0\u1eddng g\u1eb7p l\u00e0 ho, s\u1ed1t v\u00e0 c\u00f3 th\u1ec3 k\u00e8m theo theo nhi\u1ec5m tr\u00f9ng c\u01a1 h\u1ed9i. Nh\u01b0ng tr\u00ean m\u1ed9t s\u1ed1 ca ghi nh\u1eadn \u0111\u01b0\u1ee3c th\u00ec th\u1ea5y tri\u1ec7u ch\u1ee9ng \u1edf tr\u1ebb em nhi\u1ec1u khi l\u00e0 bi\u1ec3u hi\u1ec7n nh\u1eb9 kh\u00f4ng c\u00f3 vi\u00eam ph\u1ed5i.<\/p>\n

2.1. Ng\u01b0\u1eddi b\u1ec7nh vi\u00eam ph\u1ed5i c\u1ea5p kh\u00f4ng n\u1eb7ng\/n\u1eb7ng nh\u01b0ng ch\u01b0a c\u00f3 bi\u1ebfn ch\u1ee9ng\u00a0<\/b><\/h3>\n

– Kh\u00f4ng c\u1ea7n thi\u1ebft ph\u1ea3i c\u00f3 ch\u1ebf \u0111\u1ed9 \u0103n \u0111\u1eb7c bi\u1ec7t dinh d\u01b0\u1ee1ng cho ng\u01b0\u1eddi b\u1ec7nh vi\u00eam ph\u1ed5i khi ch\u01b0a c\u00f3 bi\u1ebfn ch\u1ee9ng. Song, ch\u1ebf \u0111\u1ed9 \u0103n c\u0169ng r\u1ea5t quan tr\u1ecdng v\u00ec n\u00f3 \u1ea3nh h\u01b0\u1edfng tr\u1ef1c ti\u1ebfp \u0111\u1ebfn s\u1ee9c kh\u1ecfe chung c\u1ee7a c\u01a1 th\u1ec3 v\u00e0 ch\u1ee9c n\u0103ng c\u1ee7a h\u1ec7 mi\u1ec5n d\u1ecbch.<\/p>\n

– Tr\u1ebb b\u00fa m\u1eb9 n\u00ean ti\u1ebfp t\u1ee5c duy tr\u00ec b\u00fa m\u1eb9. N\u1ebfu tr\u1ebb kh\u00f3 b\u00fa c\u00f3 th\u1ec3 v\u1eaft s\u1eefa v\u00e0 \u0111\u1ed5 th\u00eca cho tr\u1ebb. Cho \u0103n th\u01b0\u1eddng xuy\u00ean v\u00e0 \u00edt m\u1ed9t n\u1ebfu tr\u1ebb \u0103n k\u00e9m, n\u00f4n b\u1edfi \u1ea3nh h\u01b0\u1edfng c\u1ee7a ho,ng\u1ea1t m\u0169i, t\u1eb7c m\u0169i, s\u1ed1t\u2026<\/p>\n

– Tr\u1ebb c\u1ea7n \u0103n \u0111\u1ee7 v\u00e0 c\u00e2n b\u1eb1ng dinh d\u01b0\u1ee1ng v\u00e0 \u0111\u1ed9 th\u00f4 theo l\u1ee9a tu\u1ed5i, \u0111\u1ea3m b\u1ea3o nh\u1eadn \u0111\u1ee7 dinh d\u01b0\u1ee1ng theo khuy\u1ebfn ngh\u1ecb theo tu\u1ed5i.<\/p>\n

– Ngo\u00e0i ra s\u1eefa c\u00f4ng th\u1ee9c l\u00e0 m\u1ed9t s\u1ea3n ph\u1ea9m dinh d\u01b0\u1ee1ng v\u00e0 h\u1ee3p l\u00fd cho tr\u1ebb nh\u1ecf khi m\u1eb9 kh\u00f4ng c\u00f3 ho\u1eb7c thi\u1ebfu s\u1eefa.<\/p>\n

\u00a0L\u01b0u \u00fd: Tr\u1ebb th\u01b0\u1eddng ho, th\u1edf nhanh n\u00ean \u0103n d\u1ec5 n\u00f4n tr\u1edb v\u00ec v\u1eady n\u00ean cho tr\u1ebb \u0103n nh\u1eb9, l\u1ecfng h\u01a1n b\u00ecnh th\u01b0\u1eddng v\u00ec s\u1ebd kh\u00f4ng g\u00e2y k\u00edch \u1ee9ng ho trong khi nu\u1ed1t, g\u00e2y kh\u00f3 th\u1edf do d\u1ea1 d\u00e0y \u0111\u1ea7y ho\u1eb7c t\u0103ng n\u0103ng l\u01b0\u1ee3ng ti\u00eau hao c\u0169ng nh\u01b0 nh\u1ecbp tim nhanh \u0111\u1ec3 ti\u00eau h\u00f3a th\u1ee9c \u0103n. Tr\u00e1nh th\u1ee9c \u0103n g\u00e2y n\u00f4n v\u00e0 bu\u1ed3n n\u00f4n b\u1eb1ng nh\u1eefng kh\u1ea9u v\u1ecb tr\u1ebb th\u00edch, th\u1ee9c \u0103n d\u1ec5 ti\u00eau h\u00f3a v\u00e0 c\u00f3 gi\u00e1 tr\u1ecb dinh d\u01b0\u1ee1ng cao.<\/p>\n

2.2. Cho vi\u00eam ph\u1ed5i c\u1ea5p n\u1eb7ng\/bi\u1ebfn ch\u1ee9ng n\u1eb7ng t\u1ea1i PICU\u00a0<\/b><\/h3>\n

Nguy\u00ean t\u1eafc chung:<\/p>\n

– Cho dinh d\u01b0\u1ee1ng ti\u00eau h\u00f3a s\u1edbm, n\u1ebfu kh\u00f4ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/p>\n

– Ki\u1ec3m so\u00e1t d\u1ecbch v\u00e0 \u0111i\u1ec7n gi\u1ea3i<\/p>\n

– Ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng c\u1ea7n \u0111\u1ee7 n\u0103ng l\u01b0\u1ee3ng \u0111\u1ec3 \u0111\u00e1p \u1ee9ng nhu c\u1ea7u chuy\u1ec3n h\u00f3a c\u01a1 b\u1ea3n ti\u00eau hao l\u00fac ngh\u1ec9 ng\u01a1i, \u0111\u1ee7 protid nh\u1eb1m ng\u0103n ng\u1eeba d\u1ecb h\u00f3a protid, \u0111\u1ee7 vi ch\u1ea5t dinh d\u01b0\u1ee1ng, duy tr\u00ec t\u0103ng tr\u01b0\u1edfng, ph\u00e1t tri\u1ec3n cho tr\u1ebb<\/p>\n

– Khuy\u1ebfn c\u00e1o \u0111o chuy\u1ec3n h\u00f3a n\u0103ng l\u01b0\u1ee3ng gi\u00e1n ti\u1ebfp (IC) \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh nhu c\u1ea7u n\u0103ng l\u01b0\u1ee3ng cho tr\u1ebb b\u1ec7nh n\u1eb7ng t\u1ea1i PICU<\/p>\n

2.3. Cho b\u1ec7nh nhi ECMO\u00a0<\/b><\/h3>\n

2.3.1. Nguy\u00ean t\u1eafc:<\/h4>\n

– \u0102n \u0111\u01b0\u1eddng ru\u1ed9t (nh\u01b0 dinh d\u01b0\u1ee1ng qua \u1ed1ng th\u00f4ng) s\u1edbm l\u00e0 an to\u00e0n.<\/p>\n

– Dinh d\u01b0\u1ee1ng \u1ed1ng th\u00f4ng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n khi \u0111i\u1ec3m VIS <14 (Vasoactive Inotropic Support Score) (t\u1ee9c l\u00e0 khi b\u1ec7nh nh\u00e2n trong t\u00ecnh tr\u1ea1ng \u1ed5n \u0111\u1ecbnh), t\u1ed1t nh\u1ea5t l\u00e0 VIS <10.<\/p>\n

– Gi\u1ea3m thi\u1ec3u c\u00e1c y\u1ebfu t\u1ed1 g\u00e2y tr\u00ec ho\u00e3n dinh d\u01b0\u1ee1ng ti\u00eau h\u00f3a (c\u00e1c can thi\u1ec7p g\u00e2y nh\u1ecbn \u0103n qua ti\u00eau h\u00f3a) s\u1ebd gi\u00fap \u0111\u1ea1t \u0111\u01b0\u1ee3c dinh d\u01b0\u1ee1ng t\u1ed1i \u01b0u<\/p>\n

– Khuy\u1ebfn c\u00e1o \u0111o nhi\u1ec7t l\u01b0\u1ee3ng gi\u00e1n ti\u1ebfp v\u00e0 kh\u00ed m\u00e1u tr\u01b0\u1edbc v\u00e0 sau m\u00e1y t\u1ea1o oxy c\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh ti\u00eau hao n\u0103ng l\u01b0\u1ee3ng l\u00fac ngh\u1ec9 (REE- Resting Energy Expenditure)<\/p>\n

– Dinh d\u01b0\u1ee1ng t\u0129nh m\u1ea1ch c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c c\u00e1c m\u1ee5c ti\u00eau dinh d\u01b0\u1ee1ng<\/p>\n

2.3.2. H\u1ed7 tr\u1ee3 dinh d\u01b0\u1ee1ng cho b\u1ec7nh nhi ECMO<\/h4>\n

– Th\u1eddi gian cho \u0103n s\u1edbm n\u1ebfu c\u00f3 th\u1ec3. Ch\u1eadm nh\u1ea5t 48-72 gi\u1edd, ngay c\u1ea3 khi b\u1ec7nh nh\u00e2n \u0111ang d\u00f9ng thu\u1ed1c v\u1eadn m\u1ea1ch.<\/p>\n

– Dinh d\u01b0\u1ee1ng qua ti\u00eau h\u00f3a (DDTH) n\u00ean \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u sau giai \u0111o\u1ea1n h\u1ed3i s\u1ee9c c\u1ee7a b\u1ec7nh nh\u00e2n, khi li\u1ec1u l\u01b0\u1ee3ng c\u1ee7a v\u1eadn m\u1ea1ch v\u00e0 thu\u1ed1c t\u0103ng co b\u00f3p \u1ed5n \u0111\u1ecbnh (VIS<10, the Vasoactive-Inotropic Score-VIS), v\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a gi\u1ea3m t\u01b0\u1edbi m\u00e1u, \u0111\u00e3 \u0111\u1ea1t \u0111\u01b0\u1ee3c.<\/p>\n

– \u00c1p l\u1ef1c cao\/ ch\u1ec9 s\u1ed1 VIS >10. VIS l\u00e0 t\u1ed5ng c\u1ee7a c\u00e1c \u0111i\u1ec3m sau:<\/p>\n

1* li\u1ec1u dopamin (\u00b5g\/kg\/ph\u00fat) + 1* li\u1ec1u dobutamin (\u00b5g\/kg\/ph\u00fat) +<\/p>\n

100li\u1ec1u epinephrine (\u00b5g\/kg\/ph\u00fat) + 100 li\u1ec1u norepinephrine (\u00b5g\/kg\/ph\u00fat)+<\/p>\n

10* milrinone (\u00b5g\/kg\/ph\u00fat) + 10000* li\u1ec1u vasopresin (U\/kg\/ph\u00fat)<\/p>\n

– Ki\u1ec3m tra kh\u1ea3 n\u0103ng dung n\u1ea1p v\u1edbi ch\u1ea5t l\u1ecfng tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u cho \u0103n dinh d\u01b0\u1ee1ng qua \u1ed1ng th\u00f4ng, c\u00e1ch th\u1ef1c hi\u1ec7n:<\/p>\n

\u25cb Cho 100 ml n\u01b0\u1edbc qua sonde d\u1ea1 d\u00e0y trong kho\u1ea3ng th\u1eddi gian ba gi\u1edd v\u00e0 th\u1ef1c hi\u1ec7n 2 l\u1ea7n li\u00ean ti\u1ebfp<\/p>\n

\u25cb C\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u dinh d\u01b0\u1ee1ng \u1ed1ng th\u00f4ng, n\u1ebfu d\u1ecbch t\u1ed3n d\u01b0 d\u1ea1 d\u00e0y < 200 ml trong hai l\u1ea7n th\u1eed li\u00ean ti\u1ebfp<\/p>\n

– Nguy\u00ean t\u1eafc v\u00e0 c\u00e1ch ti\u1ebfn h\u00e0nh t\u01b0\u01a1ng t\u1ef1 nh\u01b0 dinh d\u01b0\u1ee1ng cho ng\u01b0\u1eddi b\u1ec7nh n\u1eb7ng \u1edf PICU, nh\u01b0:<\/p>\n

\u25cb B\u1eaft \u0111\u1ea7u cho \u0103n v\u1edbi th\u1ec3 t\u00edch \u00edt v\u00e0 t\u1ed1c \u0111\u1ed9 ch\u1eadm, sau \u0111\u00f3 t\u0103ng d\u1ea7n v\u00e0 \u0111\u1ea1t 75-80% \u0111\u00edch nhu c\u1ea7u t\u01b0\u01a1ng t\u1ef1 nh\u01b0 b\u1ec7nh nh\u00e2n n\u1eb7ng ICU trong cu\u1ed1i tu\u1ea7n \u0111\u1ea7u ti\u00ean.<\/p>\n

\u25cb Ch\u1ecdn c\u00f4ng th\u1ee9c dinh d\u01b0\u1ee1ng ti\u00eau h\u00f3a ph\u00f9 h\u1ee3p v\u1edbi b\u1ec7nh l\u00fd v\u00e0 kh\u1ea3 n\u0103ng dung n\u1ea1p c\u1ee7a \u0111\u01b0\u1eddng ti\u00eau h\u00f3a<\/p>\n

\u25cb Theo d\u00f5i t\u1ed3n l\u01b0u\/ d\u01b0 d\u1ea1 d\u00e0y m\u1ed7i 6 ti\u1ebfng trong ng\u00e0y \u0111\u1ea7u ti\u00ean c\u1ee7a dinh d\u01b0\u1ee1ng \u1ed1ng th\u00f4ng; m\u1ed7i 12 ti\u1ebfng trong ng\u00e0y th\u1ee9 hai v\u00e0 h\u00e0ng ng\u00e0y trong nh\u1eefng ng\u00e0y ti\u1ebfp theo, nh\u1eb1m gi\u1ea3m nguy c\u01a1 h\u00edt s\u1eb7c v\u00e0 vi\u00eam ph\u1ed5i li\u00ean quan \u0111\u1ebfn th\u1edf m\u00e1y<\/p>\n

\u25cb T\u1ef1a \u0111\u1ea7u c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c gi\u1eef cao h\u01a1n 30 \u0111\u1ed9.<\/p>\n

T\u00f3m l\u1ea1i, dinh d\u01b0\u1ee1ng cho tr\u1ebb m\u1eafc COVID-19 r\u1ea5t quan tr\u1ecdng, gi\u00fap qu\u00e1 tr\u00ecnh ph\u1ee5c h\u1ed3i c\u1ee7a tr\u1ebb nhanh ch\u00f3ng v\u00e0 b\u1ea3o v\u1ec7 s\u1ee9c kh\u1ecfe m\u1ed9t c\u00e1ch to\u00e0n di\u1ec7n, ng\u0103n ng\u1eeba c\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ee7a b\u1ec7nh COVID-19 g\u00e2y ra.<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"

Dinh d\u01b0\u1ee1ng \u0111\u00f3ng vai tr\u00f2 r\u1ea5t quan tr\u1ecdng trong s\u1ef1 ph\u00e1t tri\u1ec3n to\u00e0n di\u1ec7n c\u1ee7a con ng\u01b0\u1eddi \u0111\u1eb7c bi\u1ec7t trong giai \u0111o\u1ea1n ph\u00e1t tri\u1ec3n c\u1ee7a tr\u1ebb em. Khi m\u1eafc b\u1ec7nh th\u00ec dinh d\u01b0\u1ee1ng c\u00e2n b\u1eb1ng v\u00e0 h\u1ee3p l\u00fd l\u1ea1i c\u00e0ng quan tr\u1ecdng h\u01a1n bao gi\u1edd h\u1ebft b\u1edfi n\u00f3 gi\u00fap c\u01a1 th\u1ec3 t\u0103ng c\u01b0\u1eddng h\u1ec7 mi\u1ec5n […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[3],"yoast_head":"\nCh\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng trong \u0111i\u1ec1u tr\u1ecb tr\u1ebb em nhi\u1ec5m COVID-19 - Vinmec<\/title>\n<meta name=\"description\" content=\"Do s\u1ef1 b\u00f9ng n\u1ed5 c\u1ee7a \u0111\u1ea1i d\u1ecbch Covid 19 tr\u00ean to\u00e0n c\u1ea7u, tuy t\u1ef7 l\u1ec7 m\u1eafc \u1edf tr\u1ebb em ch\u01b0a cao nh\u01b0ng vi\u1ec7c \u0111\u01b0a ra h\u01b0\u1edbng d\u1eabn h\u1ed7 tr\u1ee3 dinh d\u01b0\u1ee1ng cho ...\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng trong \u0111i\u1ec1u tr\u1ecb tr\u1ebb em nhi\u1ec5m COVID-19 - 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