Approach to Dehydration in Children

Yazarlar

Sadiye Sert

Özet

Dehydration due to gastroenteritis in children is a common condition. Paediatricians can assess the extent of dehydration through a history and physical examination. The severity of electrolyte imbalances and dehydration may be assessed using the results of laboratory tests conducted on a sample of severe cases. The first choice should be oral rehydration solution when a child can be fed orally and has just mild dehydration. Severe dehydration in infants can be deadly or very morbid. In order to restore the whole fluid deficit in severe situations, it should be treated straight soon via parenteral route. Dehydration in children has a good prognosis when properly treated.

Referanslar

Vega RM, Avva U. Pediatric Dehydration. 2022 Nov 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 28613793.

Steiner MJ, DeWalt DA, Byerley JS. Is this child dehydrated? Journal of the American Medical Association. 2004; 291 (22): 2746-2754. doi: 10.1001/jama.291.22.2746.

Mahajan P, Dehydration. In: McInerny TK, Adam HM, Campbell DE, DeWitt TG, Foy JM, Kamat DM, eds. American Academy of Pediatrics Textbook of Pediatric Care. 2nd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2017. p.2805-2813.

Santillanes G, Rose E. Evaluation and Management of Dehydration in Children. Emergency medicine clinics of North America. 2018;36(2): 259-273.doi:10.1016/j.emc.2017.12.004.

Powers KS. Dehydration: Isonatremic, Hyponatremic, and Hypernatremic Recognition and Management. Pediatrics in review. 2015;36(7): 274-283. doi: 10.1542/pir.36-7-274.

Whitehead FJ, Couper RT, Moore L, et al. Dehydration deaths in infants and young children. The American journal of forensic medicine and pathology. 1996;17(1): 73-78. doi: 10.1097/00000433-199603000-00014.

Omatola CA, Olaniran AO. Rotaviruses: From Pathogenesis to Disease Control-A Critical Review. Viruses. 2022;14(5): 875. doi: 10.3390/v14050875

Guarino A, Ashkenazi S, Gendrel D, et al; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition; European Society for Pediatric Infectious Diseases. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. Journal of pediatric gastroenterology and nutrition. 2014;59(1): 132-152. doi: 10.1097/MPG.0000000000000375.

Zieg J, Narla D, Gonsorcikova L, et al. Fluid management in children with volume depletion. Pediatric Nephrology. 2023 Jul 14. doi: 10.1007/s00467-023-06080-z. Epub ahead of print. PMID: 37452205.

Colletti JE, Brown KM, Sharieff GQ, et al. The management of children with gastroenteritis and dehydration in the emergency department. The Journal of emergency medicine. 2010;38(5): 686–698. doi: 10.1016/j.jemermed.2008.06.015.

King CK, Glass R, Bresee JS, et al, Centers for Disease Control and Prevention. Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR. Recommendations and reports. 2003;52(RR-16): 1-16.

Hoxha TF, Azemi M, Avdiu M, et al. The usefulness of clinical and laboratory parameters for predicting severity of dehydration in children with acute gastroenteritis. Medical archives.2014;68: 304–305. doi: 10.5455/medarh.2014.68.304-307.

Canavan A, Arant BS Jr. Diagnosis and management of dehydration in children. American family physician.2009;80(7): 692-696.

Porter SC, Fleisher GR, Kohane IS, et al. The value of parental report for diagnosis and management of dehydration in the emergency department. Annals of emergency medicine.2003;41(2): 196-205. doi: 10.1067/mem.2003.5.

Armon K, Stephenson T, MacFaul R, et al. An evidence and consensus based guideline for acute diarrhoea management. Archives of disease in childhood. 2001;85(2): 132-142. doi: 10.1136/adc.85.2.132.

Gorelick MH, Shaw KN, Murphy KO, et al. Effect of fever on capillary refill time. Pediatric emergency care. 1997;13(5): 305-307. doi: 10.1097/00006565-199710000-00001.

Greenbaum LA, Deficit Therapy.In: Kliegman RM, Joseph WSG, Blum NJ, et al. Nelson textbook of pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020. p. 429-432.e1

Friedman JN, Goldman RD, Srivastava R, et al. Development of a clinical dehydration scale for use in children between 1 and 36 months of age. The Journal of pediatrics. 2004;145(2): 201-207. doi: 10.1016/j.jpeds.2004.05.035.

Chen L, Kim Y, Santucci KA. Use of ultrasound measurement of the inferior vena cava diameter as an objective tool in the assessment of children with clinical dehydration. Academic emergency medicine. 2007;14(10): 841-845. doi: 10.1197/j.aem.2007.06.040.

Somers MJ. Clinical assessment of hypovolemia (dehydration) in children. https://www.uptodate.com/contents/clinical-assessment-of-hypovolemia-dehydration-in-children?search=dehydration%20in%20children&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1(Accessed 15th August 2023.)

McConnochie KM, Conners GP, Lu E, et al. How commonly are children hospitalized for dehydration eligible for care in alternative settings? Archives of pediatrics & adolescent medicine.1999;153: 1233-1241. doi: 10.1001/archpedi.153.12.1233.

Jackson J, Bolte RG. Risks of intravenous administration of hypotonic fluids for pediatric patients in ED and prehospital settings: let's remove the handle from the pump. The American journal of emergency medicine. 2000;18: 269-270. doi: 10.1016/s0735-6757(00)90119-0.

Ayus JC, Arieff AI. Hyponatremia and myelinolysis. Annals of internal medicine.1997; 127: 163. 10.7326/0003-4819-127-2-199707150-00016

Moineau G, Newman J. Rapid intravenous rehydration in the pediatric emergency department. Pediatric emergency care. 1990;6: 186-188. doi: 10.1097/00006565-199009000-00005.

Rahman O, Bennish ML, Alam AN, Salam MA. Rapid intravenous rehydration by means of a single polyelectrolyte solution with or without dextrose. The Journal of paediatrics. 1988; 113: 654-660. doi: 10.1016/s0022-3476(88)80374-3.

Reid SR, Bonadio WA. Outpatient rapid intravenous rehydration to correct dehydration and resolve vomiting in children with acute gastroenteritis. Annals of emergency medicine.1996; 28: 318-323. doi: 10.1016/s0196-0644(96)70032-x.

Strange K. Regulation of solute and water balance and cell volume in the central nervous system. Journal of the American Society of Nephrology. 1992; 3: 12-27. doi: 10.1681/ASN.V3112.

Schwartz R. Comments from another student of Gamble and Darrow on fluids. Pediatrics. 1996; 98(2Pt1): 314.

Sterns RH, Cappuccio JD, Silver SM, et al. Neurologic sequelae after treatment of severe hyponatremia: a multicenter perspective. Journal of the American Society of Nephrology. 1994; 4: 1522-1530. doi: 10.1681/ASN.V481522.

Somers MJ. Treatment of hypovolemia (dehydration) in children in resource-rich settings. https://www.uptodate.com/contents/treatment-of-hypovolemia-dehydration-inchildren-in-resourcerichsettings?search=Treatment%20of%20hypovolemia%20(dehydration)%20in%20children%20in%20resourcerich%20settings&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 (Accessed 15th August 2023.)

Berl T. Treating hyponatremia: damned if we do and damned if we don't. Kidney international.1990; 37: 1006-1018. doi: 10.1038/ki.1990.78.

Karp BI, Laureno R. Pontine and extrapontine myelinolysis: a neurologic disorder following rapid correction of hyponatremia. Medicine (Baltimore). 1993; 72:359-373

Finberg L. Hypernatremic (hypertonic) dehydration in infants. The New England journal of medicine. 1973; 289: 196-198. doi: 10.1056/NEJM197307262890407.

Blum D, Brasseur D, Kahn A, et al. Safe oral rehydration of hypertonic dehydration. Journal of pediatric gastroenterology and nutrition.1986; 5: 232-235.

Practice parameter: the management of acute gastroenteritis in young children. American Academy of Pediatrics, Provisional Committee on Quality Improvement, Subcommittee on Acute Gastroenteritis. Pediatrics. 1996; 97: 424-435.

Buccigrossi V, Lo Vecchio A, Bruzzese E, et al. Potency of Oral Rehydration Solution in Inducing Fluid Absorption is Related to Glucose Concentration. Scientific reports. 2020;10(1):7803. doi: 10.1038/s41598-020-64818-3.

World Health Organization. Reduced osmolarity: oral rehydration salts (ORS) formulation: a report from a meeting of experts jointly organised by UNICEF and WHO: UNICEF house, New York, USA, 18 July 2001. No. WHO/FCH/CAH/01.22. World Health Organization, 2002.

Fonseca BK, Holdgate A, Craig JC. Enteral vs intravenous rehydration therapy for children with gastroenteritis: a meta-analysis of randomized controlled trials. Archives of pediatrics & adolescent medicine. 2004;158(5): 483-490. doi: 10.1001/archpedi.158.5.483.

Freedman SB, Hall M, Shah SS, et al. Impact of increasing ondansetron use on clinical outcomes in children with gastroenteritis. Journal of the American Medical Association pediatrics. 2014;168(4): 321-329. doi: 10.1001/jamapediatrics.2013.4906

Rouhani S, Meloney L, Ahn R, et al. Alternative rehydration methods: a systematic review and lessons for resource-limited care. Pediatrics. 2011; 127(3):e748-757. doi: 10.1542/peds.2010-0952.

Hanna M, Saberi MS. Incidence of hyponatremia in children with gastroenteritis treated with hypotonic intravenous fluids. Pediatric Nephrology. 2010;25(8):1471–1475. doi: 10.1007/s00467-009-1428-y.

Referanslar

Vega RM, Avva U. Pediatric Dehydration. 2022 Nov 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 28613793.

Steiner MJ, DeWalt DA, Byerley JS. Is this child dehydrated? Journal of the American Medical Association. 2004; 291 (22): 2746-2754. doi: 10.1001/jama.291.22.2746.

Mahajan P, Dehydration. In: McInerny TK, Adam HM, Campbell DE, DeWitt TG, Foy JM, Kamat DM, eds. American Academy of Pediatrics Textbook of Pediatric Care. 2nd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2017. p.2805-2813.

Santillanes G, Rose E. Evaluation and Management of Dehydration in Children. Emergency medicine clinics of North America. 2018;36(2): 259-273.doi:10.1016/j.emc.2017.12.004.

Powers KS. Dehydration: Isonatremic, Hyponatremic, and Hypernatremic Recognition and Management. Pediatrics in review. 2015;36(7): 274-283. doi: 10.1542/pir.36-7-274.

Whitehead FJ, Couper RT, Moore L, et al. Dehydration deaths in infants and young children. The American journal of forensic medicine and pathology. 1996;17(1): 73-78. doi: 10.1097/00000433-199603000-00014.

Omatola CA, Olaniran AO. Rotaviruses: From Pathogenesis to Disease Control-A Critical Review. Viruses. 2022;14(5): 875. doi: 10.3390/v14050875

Guarino A, Ashkenazi S, Gendrel D, et al; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition; European Society for Pediatric Infectious Diseases. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. Journal of pediatric gastroenterology and nutrition. 2014;59(1): 132-152. doi: 10.1097/MPG.0000000000000375.

Zieg J, Narla D, Gonsorcikova L, et al. Fluid management in children with volume depletion. Pediatric Nephrology. 2023 Jul 14. doi: 10.1007/s00467-023-06080-z. Epub ahead of print. PMID: 37452205.

Colletti JE, Brown KM, Sharieff GQ, et al. The management of children with gastroenteritis and dehydration in the emergency department. The Journal of emergency medicine. 2010;38(5): 686–698. doi: 10.1016/j.jemermed.2008.06.015.

King CK, Glass R, Bresee JS, et al, Centers for Disease Control and Prevention. Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR. Recommendations and reports. 2003;52(RR-16): 1-16.

Hoxha TF, Azemi M, Avdiu M, et al. The usefulness of clinical and laboratory parameters for predicting severity of dehydration in children with acute gastroenteritis. Medical archives.2014;68: 304–305. doi: 10.5455/medarh.2014.68.304-307.

Canavan A, Arant BS Jr. Diagnosis and management of dehydration in children. American family physician.2009;80(7): 692-696.

Porter SC, Fleisher GR, Kohane IS, et al. The value of parental report for diagnosis and management of dehydration in the emergency department. Annals of emergency medicine.2003;41(2): 196-205. doi: 10.1067/mem.2003.5.

Armon K, Stephenson T, MacFaul R, et al. An evidence and consensus based guideline for acute diarrhoea management. Archives of disease in childhood. 2001;85(2): 132-142. doi: 10.1136/adc.85.2.132.

Gorelick MH, Shaw KN, Murphy KO, et al. Effect of fever on capillary refill time. Pediatric emergency care. 1997;13(5): 305-307. doi: 10.1097/00006565-199710000-00001.

Greenbaum LA, Deficit Therapy.In: Kliegman RM, Joseph WSG, Blum NJ, et al. Nelson textbook of pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020. p. 429-432.e1

Friedman JN, Goldman RD, Srivastava R, et al. Development of a clinical dehydration scale for use in children between 1 and 36 months of age. The Journal of pediatrics. 2004;145(2): 201-207. doi: 10.1016/j.jpeds.2004.05.035.

Chen L, Kim Y, Santucci KA. Use of ultrasound measurement of the inferior vena cava diameter as an objective tool in the assessment of children with clinical dehydration. Academic emergency medicine. 2007;14(10): 841-845. doi: 10.1197/j.aem.2007.06.040.

Somers MJ. Clinical assessment of hypovolemia (dehydration) in children. https://www.uptodate.com/contents/clinical-assessment-of-hypovolemia-dehydration-in-children?search=dehydration%20in%20children&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1(Accessed 15th August 2023.)

McConnochie KM, Conners GP, Lu E, et al. How commonly are children hospitalized for dehydration eligible for care in alternative settings? Archives of pediatrics & adolescent medicine.1999;153: 1233-1241. doi: 10.1001/archpedi.153.12.1233.

Jackson J, Bolte RG. Risks of intravenous administration of hypotonic fluids for pediatric patients in ED and prehospital settings: let's remove the handle from the pump. The American journal of emergency medicine. 2000;18: 269-270. doi: 10.1016/s0735-6757(00)90119-0.

Ayus JC, Arieff AI. Hyponatremia and myelinolysis. Annals of internal medicine.1997; 127: 163. 10.7326/0003-4819-127-2-199707150-00016

Moineau G, Newman J. Rapid intravenous rehydration in the pediatric emergency department. Pediatric emergency care. 1990;6: 186-188. doi: 10.1097/00006565-199009000-00005.

Rahman O, Bennish ML, Alam AN, Salam MA. Rapid intravenous rehydration by means of a single polyelectrolyte solution with or without dextrose. The Journal of paediatrics. 1988; 113: 654-660. doi: 10.1016/s0022-3476(88)80374-3.

Reid SR, Bonadio WA. Outpatient rapid intravenous rehydration to correct dehydration and resolve vomiting in children with acute gastroenteritis. Annals of emergency medicine.1996; 28: 318-323. doi: 10.1016/s0196-0644(96)70032-x.

Strange K. Regulation of solute and water balance and cell volume in the central nervous system. Journal of the American Society of Nephrology. 1992; 3: 12-27. doi: 10.1681/ASN.V3112.

Schwartz R. Comments from another student of Gamble and Darrow on fluids. Pediatrics. 1996; 98(2Pt1): 314.

Sterns RH, Cappuccio JD, Silver SM, et al. Neurologic sequelae after treatment of severe hyponatremia: a multicenter perspective. Journal of the American Society of Nephrology. 1994; 4: 1522-1530. doi: 10.1681/ASN.V481522.

Somers MJ. Treatment of hypovolemia (dehydration) in children in resource-rich settings. https://www.uptodate.com/contents/treatment-of-hypovolemia-dehydration-inchildren-in-resourcerichsettings?search=Treatment%20of%20hypovolemia%20(dehydration)%20in%20children%20in%20resourcerich%20settings&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 (Accessed 15th August 2023.)

Berl T. Treating hyponatremia: damned if we do and damned if we don't. Kidney international.1990; 37: 1006-1018. doi: 10.1038/ki.1990.78.

Karp BI, Laureno R. Pontine and extrapontine myelinolysis: a neurologic disorder following rapid correction of hyponatremia. Medicine (Baltimore). 1993; 72:359-373

Finberg L. Hypernatremic (hypertonic) dehydration in infants. The New England journal of medicine. 1973; 289: 196-198. doi: 10.1056/NEJM197307262890407.

Blum D, Brasseur D, Kahn A, et al. Safe oral rehydration of hypertonic dehydration. Journal of pediatric gastroenterology and nutrition.1986; 5: 232-235.

Practice parameter: the management of acute gastroenteritis in young children. American Academy of Pediatrics, Provisional Committee on Quality Improvement, Subcommittee on Acute Gastroenteritis. Pediatrics. 1996; 97: 424-435.

Buccigrossi V, Lo Vecchio A, Bruzzese E, et al. Potency of Oral Rehydration Solution in Inducing Fluid Absorption is Related to Glucose Concentration. Scientific reports. 2020;10(1):7803. doi: 10.1038/s41598-020-64818-3.

World Health Organization. Reduced osmolarity: oral rehydration salts (ORS) formulation: a report from a meeting of experts jointly organised by UNICEF and WHO: UNICEF house, New York, USA, 18 July 2001. No. WHO/FCH/CAH/01.22. World Health Organization, 2002.

Fonseca BK, Holdgate A, Craig JC. Enteral vs intravenous rehydration therapy for children with gastroenteritis: a meta-analysis of randomized controlled trials. Archives of pediatrics & adolescent medicine. 2004;158(5): 483-490. doi: 10.1001/archpedi.158.5.483.

Freedman SB, Hall M, Shah SS, et al. Impact of increasing ondansetron use on clinical outcomes in children with gastroenteritis. Journal of the American Medical Association pediatrics. 2014;168(4): 321-329. doi: 10.1001/jamapediatrics.2013.4906

Rouhani S, Meloney L, Ahn R, et al. Alternative rehydration methods: a systematic review and lessons for resource-limited care. Pediatrics. 2011; 127(3):e748-757. doi: 10.1542/peds.2010-0952.

Hanna M, Saberi MS. Incidence of hyponatremia in children with gastroenteritis treated with hypotonic intravenous fluids. Pediatric Nephrology. 2010;25(8):1471–1475. doi: 10.1007/s00467-009-1428-y.

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