What is the fluid of choice during resuscitation of child with severe malnutrition and shock
**Core Concept**
The fluid of choice during resuscitation of a child with severe malnutrition and shock is a critical decision, considering the child's compromised nutritional status and potential fluid shifts. In such cases, the ideal fluid should provide necessary volume expansion, electrolytes, and glucose for energy.
**Why the Correct Answer is Right**
During resuscitation, the child's body needs an isotonic fluid that can provide necessary electrolytes and glucose. Normal saline or 0.9% saline is isotonic, but it lacks glucose. Therefore, a more suitable option would be Ringer's lactate or a similar fluid that contains lactate, which can provide energy in the form of pyruvate, as well as necessary electrolytes. Additionally, Ringer's lactate has a pH closer to physiological pH, which is beneficial in children with severe malnutrition and shock.
**Why Each Wrong Option is Incorrect**
**Option A:** Normal saline is isotonic but lacks glucose, making it less ideal for children with severe malnutrition.
**Option B:** Dextrose is not the primary fluid of choice during resuscitation, especially in children with severe malnutrition and shock, as it does not provide necessary electrolytes.
**Option C:** Hypertonic saline is not the first-line fluid for resuscitation in children with severe malnutrition and shock, as it can lead to fluid shifts and potential complications.
**Clinical Pearl / High-Yield Fact**
In children with severe malnutrition and shock, Ringer's lactate is a better choice than normal saline due to its ability to provide energy in the form of pyruvate and necessary electrolytes.
**Correct Answer:** Ringer's lactate