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[Dehydration due to gastro-enteritis in children]
J E Kist-van Holthe1, A J van der Heijden
1Academisch Ziekenhuis, Kinder-en Jeugdcentrum, Leiden.
Insights
Gastroenteritis frequently causes dehydration in children. Prompt oral rehydration salts (ORS) and early feeding are key, with nasogastric or intravenous rehydration for severe cases.
Area of Science:
- Pediatrics
- Gastroenterology
- Emergency Medicine
Background:
- Gastroenteritis is a leading cause of dehydration in pediatric populations.
- Infants and young children are at higher risk due to physiological factors like higher extracellular volume and immature renal concentrating capacity.
Purpose of the Study:
- To outline the management of dehydration secondary to gastroenteritis in children.
- To emphasize the importance of timely rehydration and nutritional support.
Main Methods:
- Review of current clinical guidelines and evidence for managing pediatric gastroenteritis-associated dehydration.
- Focus on oral rehydration therapy (ORT) and criteria for escalating care.
Main Results:
- Oral rehydration with oral rehydration salts (ORS) is effective in most cases.
- Early refeeding (< 6-24 hours) is crucial for recovery.
- Nasogastric tube feeding is a viable alternative if oral rehydration fails at home.
- Intravenous rehydration is indicated for dehydration exceeding 10% body weight.
Conclusions:
- Effective management of childhood gastroenteritis dehydration relies on prompt assessment and appropriate fluid therapy.
- Oral rehydration and early feeding should be prioritized, with alternative methods available for refractory cases.
Abstract:
Gastroenteritis is the commonest cause of dehydration in children. Infants and young children dehydrate more easily than adults if fluid intake is insufficient or fluid loss too high because of the combination of a large extracellular volume, a large insensible loss and a mediocre concentrating capacity of the kidney. Fluid loss due to gastroenteritis is often accompanied by electrolyte and acid-base disturbances. Oral rehydration with oral rehydration salts (ORS) is nearly always possible. Re-evaluation after 6 hours is advised especially in young children. Early (< 6-24 hours) resumption of feeding is important. If rehydration with frequent small amounts of ORS at home fails, continuous nasogastric tube feeding in the hospital is a good alternative. In dehydration exceeding 10% of body weight intravenous rehydration is necessary.