Dehydration

Hyponatremia / hypernatremia
Mild / moderate / severe dehydration

  • Describe the fluid composition of the body, the body water compartments and the normal movement of fluids and electrolytes between compartments
  • Describe clinical signs and symptoms of dehydration
  • Describe principles of rehydration, both oral and intravenous

Overview & Foundational Knowledge

Ruth JL & Wassner SJ. Body composition: Salt and water. Pediatrics in Review 2006; 27(5), 181-187.

Review of the different body fluid compartments, the percentage of body fluid with different ages and the equilibrium between extracellular fluid and intracellular fluid. Listing of the daily requirements for sodium and a discussion of the relationship between serum sodium concentration and total body sodium content.

Clinical Resources

Shafiee MAS, Bohn D, Hoorn EJ & Halperin ML. How to select optimal maintenance intravenous fluid therapy. Q J Med 2003; 96, 601–610.

http://qjmed.oxfordjournals.org/content/96/8/601.full.pdf+html

Adult orientated but a good commentary about the risks of hyponatraemia and advice about the indications for fluid management.

Colletti JE et al. The management of children with gastroenteritis and dehydration in the emergency department. The Journal of Emergency Medicine 2010; 38(5) 686-698.

Evidence on the assessment of dehydration, methods of rehydration (IV versus oral), and the utility of antiemetics in the child presenting with acute gastroenteritis

Moritz ML & Ayus JC. Intravenous fluid management for the acutely ill child. Current Opinion in Pediatrics 2011; 23, 186-193.

Risk of acute hyponatremia in hospitalized children and youth receiving maintenance intravenous fluids.

Risk of acute hyponatremia in hospitalized children and youth receiving maintenance intravenous fluids

http://www.cps.ca/documents/position/acute-hyponatremia-in-hospitalized-children-and-youth

http://www.cps.ca/fr/documents/position/hyponatremie-aigue-chez-les-enfants-et-les-adolescents-hospitalises

Canadian Paediatric Society Practice Point (2016)

Great overview of the dangers of hyponatremia in the inpatient population in pediatrics

Meyers RS. Pediatric Fluid and Electrolyte Therapy. Journal of Pediatric Pharmacology and Therapeutics 2009; 14(4), 204–211.

Written for pharmacists but a nice simple overview of intravenous fluids.

Virtual Patients or Cases

Dehydration

https://www.pedscases.com/

Podcast and two quizzes related to dehydration in children.

Clinical Presentations