Dehydration in children – symptoms, treatment

Proven content

Dehydration is a dangerous condition where your body’s water content is too low and can even be life-threatening. For dehydration, there may be, among others, as a result of chronic diarrhea, vomiting, excessive sweating.

Dehydration in children

Dehydration is a major concern of infants and young children worldwide, especially in developing countries, where it is a major cause of morbidity and mortality. In highly industrialized countries, it is one of the most common reasons for patients seeking outpatient advice.

Dehydration results from increased losses, decreased fluid intake, or both. It most often develops as a result of diarrhea, vomiting or gastroenteritis, both of which may be present together. Here, the loss of water and electrolytes occurs through the gastrointestinal tract. Another site of fluid loss is the kidneys, which are extremely important in the pathomechanism of dehydration in children with diabetes. Symptoms of dehydration can also develop through the skin that gives off excess heat in the form of sweat. Damage to its deep layers as a result of burns is also associated with the risk of excessive loss of fluids and electrolytes. Reduced fluid intake is often associated with many diseases of younger children and disorders associated with vomiting. High ambient temperature may be an unfavorable environmental factor, which increases the loss of body fluids.

Types of dehydration

There are three degrees of dehydration:

1. Mild dehydration: 5, 10 and 15% weight loss in newborns and infants and 3, 6 and 9% in older children and adults. It is associated with increased thirst and dryness of the oral mucosa.
2. Moderate dehydration: symptoms additionally include increased heart rate, weakness, and prolonged capillary recurrence.
3. Severe dehydration: a drop in blood pressure is characteristic and the child is in a very serious condition.

The degree of a child’s dehydration is assessed in two ways:

1. The first method is based on knowing the patient’s weight immediately before and after dehydration, which is very difficult in practice.
2. The second method uses the assessment of the set of clinical symptoms characteristic for each degree of dehydration. It should be noted that parents are usually not able to correctly estimate the degree of dehydration of their child. A mistake of 1 kg for a 10-year-old child equates to a misstatement of 10%, which can change the degree of dehydration from mild to severe or vice versa. In practice, it is important to diagnose moderate and severe dehydration promptly and correctly, as these children require hospital treatment and intravenous rehydration.

Help with dehydration

After dehydration has been identified and its degree assessed, the basis for the procedure is to select an appropriate method of making up for losses and securing the basic demand for fluids.

For mild to moderate dehydration, oral rehydration is the preferred method because of its efficacy, convenience, safety, and lower cost compared to intravenous hydration. Oral Irrigation Fluids (ORFs) have been composed especially for this purpose, which can be administered from the first moment of diarrhea. In the case of vomiting, ORS, preferably chilled, should be administered in small portions (5 ml every 5 minutes), e.g. with a teaspoon. DPNs also have their negative features, namely they do not affect the duration of diarrhea and the consistency of the stool, and they have a salty taste. According to the experts’ recommendations, an average of 75 ml of ORF / kg of the child’s body weight should be administered and additional current losses should be supplemented, i.e. for each diarrheal stool and episode of vomiting, 10 ml and 5 ml of ORF / kg of the child’s body weight should be administered, respectively.

Child dehydration – treatment in a hospital

Indications for hospitalization of a child with acute diarrhea:

1. ineffective watering of the DNP or refusal to take DNP,
2. shock,
3. severe dehydration,
4. neurological symptoms,
5. persistent vomiting or vomiting with bile,
6. no possibility to provide adequate treatment at home,
7. suspicion of a surgical cause,
8. a child who is apathetic, drowsy, weak, without the desire to drink or eat, pale, sometimes flaccid or excessively irritable, who has or continues to pass diarrheal stools and / or vomits, and does not want to take ADS.

Inpatient dehydration is treated by intravenous irrigation. Outpatient examinations are also performed.

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