• Med Glas (Zenica) · Feb 2014

    Fluid management in children with diarrhea-related hyponatremic-hypernatremic dehydration: a retrospective study of 83 children.

    • Celebi Kocaoglu, Ece Selma Solak, Cengizhan Kilicarslan, and Sukru Arslan.
    • 1Department of Pediatrics, 2Department of Pediatric Nephrology; Konya Education and Research Hospital, Konya, Turkey.
    • Med Glas (Zenica). 2014 Feb 1;11(1):87-93.

    AimTo investigate serum creatinine and electrolyte status of children with diarrhea-related hyponatremic or hypernatremic dehydration.MethodsMedical history of 83 patients admitted to the Pediatric Intensive Care Unit of the Konya Education and Research Hospital, Konya, Turkey with diarrhea, dehydration and electrolyte imbalance was retrospectively evaluated according to the degree of dehydration, serum creatinine, electrolytes, blood gas, approaches to the treatment such as content of given fluid, HCO3- and acute periotenal dialysis. Of 65 patients with hyponatremia, 44 (67.7%) were given fluids at appropriate concentration according to their age, and 21 (32.3%) were given fluids at higher concentration. Of 18 hypernatremic patients, 11 (61.1%) were given fluids at appropriate concentration for age, and seven (38.9%) were given fluids at higher concentration.ResultsMean duration of amelioration of serum sodium levels for those admitted with hyponatremia and given fluids at appropriate concentration for age and at higher concentration were 33.9 ± 28.3 h and 53.7 ± 31.6 h, respectively. Mean duration of amelioration of serum sodium levels for hypernatremics and given fluids at appropriate concentration for age and at higher concentration were 34.7 ± 22.1 h and 46.3 ± 32 h, respectively. Four (4.8%) hyponatremic patients and three (3.6%) with hypernatremia were treated with acute peritoneal dialysis. Mortality rate was 6% (five of all patients).ConclusionThe children with severe diarrhea should be closely followed-up as to clinical examination, serum electrolytes, creatinine and blood gases, and because no single intravenous fluid management is optimal for all children, intravenous fluid therapy should be individualized for each patient.

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