What Is Infant Dehydration?

Pediatric dehydration is due to insufficient intake or excessive loss of fluid, resulting in a decrease in total fluid volume in the body. Dehydration can be described as reaching 5% or more of body weight. When diagnosing dehydration, the degree and nature of dehydration should be distinguished so that treatment can be performed correctly.

Pediatric dehydration

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Pediatric dehydration is due to insufficient intake or excessive loss of fluid, resulting in a decrease in total fluid volume in the body. Dehydration can be described as reaching 5% or more of body weight. When diagnosing dehydration, the degree and nature of dehydration should be distinguished so that treatment can be performed correctly.

Chinese name

Pediatric dehydration

Foreign name

Pediatric dehydration

the reason

Insufficient fluid intake or excessive loss

Definition

Reach 5% or more of body weight

Division

Light, medium and severe

There are many causes of dehydration in children, the most common being acute gastroenteritis and too little fluid intake. Loss of body fluids caused by vomiting and diarrhea is the cause of dehydration caused by gastroenteritis, and it is also one of the most common causes of dehydration. Another common cause of dehydration is insufficient fluid intake, such as caused by oropharyngeal pain

Indexing of dehydration

(1) Degree of dehydration The degree of dehydration is divided into three degrees according to its severity. During the treatment, the amount of fluid replacement and the speed of fluid replacement are determined according to the light, medium and severe dehydration. Water loss in the body during mild dehydration is equivalent to 3% to 5% of body weight (weight loss of 3% to 5%), and clinical manifestations are not obvious, slightly debilitated, slightly thirsty, less urine, and normal skin elasticity. Treatment only needs to remove the cause, oral rehydration salt (ORS) granules 50 ~ 80 ml / kg, after the dehydration is corrected, the remaining amount and the same amount of water are diluted as needed for oral treatment. The total amount of liquid in 24 hours can reach 100 ~ 150 ml / kg. Newborns and children with obvious vomiting, bloating, shock, cardiorenal insufficiency, or other serious complications should not use oral rehydration. The intravenous rehydration volume is 90 to 120ml / kg, and the first replenishment is 1/2; Water loss in the body when dehydration is equivalent to 5% to 10% of body weight (5% to 10% weight loss). The clinical manifestations are more obvious, including a lack of energy or restlessness, thirst, less urine, dry lips, sunken eye sockets, and poor skin elasticity. Intravenous infusion should be used during treatment, the amount is 120 150 ml / (kg * d), supplemented according to 1/2 2/3 of the calculated amount, and the remaining amount is decided according to the condition and treatment effect; water in the body during severe dehydration Loss of more than 10% of considerable body weight. The clinical manifestations are very obvious, poor response, lack of desire, restlessness or lethargy, cold limbs, weak pulses, disappearance of skin elasticity, little or no urine, and decreased blood pressure. If not treated in a timely and correct manner, death can occur within a short period of time. Treatment must be supplemented with effective circulating blood volume intravenously, 20 ml / kg physiological saline, after rapid intravenous infusion of 0.5 to 1 hour, 60 to 80 ml / kg of intravenous infusion in 6 to 8 hours, and then corrected according to the condition and dehydration. The degree is re-entered or taken orally at 80 to 100 ml / kg, which is completed in 16 hours. If the primary disease has been controlled, the dehydration is basically corrected, and it can no longer be entered. The daily intake is not less than 200 ml / kg. In the case of children with third-degree malnutrition, pneumonia, congenital heart disease, and heart failure, the amount of fluid input is 1/2 of the calculated amount, which may be increased or decreased as appropriate.

Selection and preparation of infusion types

(2) Selection and preparation of infusion types

Depending on the nature of the dehydration. The loss of sodium in the body during hypotonic dehydration is relatively greater than the loss of water. Serum sodium <130 mmol / L, plasma osmotic pressure <280 mOsm / L, hyponatremia occurs. Shock and cerebral edema are extremely likely to occur. When treating, 2/3 sheets should be used. The preparation method is based on volume ratio, normal saline: 5% glucose solution = 2: 1. Or use physiological saline: 5% glucose: 1.4% sodium bicarbonate = 4: 3: 2.

Severe hyponatremia, when serum sodium <120 mmol / L, intravenous injection of 3% sodium chloride 12 ml / kg (5% sodium chloride 7 ml / kg); isotonic dehydration is the sodium and water in the body according to Loss of ratio, normal serum sodium, normal plasma osmotic pressure (280-310 mOsm), 1/2 sheet solution for treatment, preparation method: normal saline: 5% glucose = 1: 1, or 3: 2: 1 solution = 5 % Glucose: physiological saline: 1.4% sodium bicarbonate solution; Hypertonic dehydration is rare in clinical practice, water loss is relatively more than sodium loss, hypernatremia occurs, serum sodium> 150 mmol / L, plasma osmotic pressure> 310 mOsm / L. Clinical manifestations are not obvious but extreme thirst, oliguria, irritability, lethargy or convulsions. Treatment should use 1/3 or 1/5 of salt and sugar water, that is, normal saline: 5% glucose is 1: 2 or 1: 4. It is necessary to input slowly to correct the hypertonic state so as to avoid cerebral edema.