[Parenteral rehydration treatment of acute diarrhea]

Parenteral rehydration is mandatory if dehydration is severe, vomiting and anorexia prevails, peristalsis is abolished or consciousness disturbed. It has the aim to prevent a circulatory collapse, to fill up the deficit and maintain the requirement until oral feeding is restarted. The principles of parenteral rehydration did not change during the last 20 years. Initially a rapid infusion of isotonic Ringer's lactate solution is mandatory, which usually is followed by half isotonic Ringer's glucose solution. Hypertonic dehydration should be rehydrated very carefully and slowly. During 1976-1986 212 infants and children with severe dehydration were parenterally rehydrated in the Children's Hospital of Medical School Hannover. Dehydration was isotonic in 65.7%, hypertonic in 20.7%, and hypotonic in 13.6%. The parenteral rehydration lasted from 1 to 7 days and was longer necessary in the hypertonic and hypotonic than isotonic states. 4 infants with hypertonic dehydration showed cerebral complications, and 2 of them died. All other patients recovered quickly without acute sequelae.