Volume depletion is a common condition and a frequent cause of hospitalization in children. Proper assessment of the patient includes a detailed history and a thorough physical examination. Biochemical tests may be useful in selected cases. Understanding the pathophysiology of fluid balance is necessary for appropriate management. A clinical dehydration scale assessing more physical findings may help to determine dehydration severity. Most dehydrated children can be treated orally; however, intravenous therapy may be indicated in patients with severe volume depletion, in those who have failed oral therapy, or in children with altered consciousness or significant metabolic abnormalities. Proper management consists of restoring circulatory volume and electrolyte balance. In this paper, we review clinical aspects, diagnosis, and management of children with volume depletion.
- MeSH
- Dehydration * diagnosis etiology therapy MeSH
- Child MeSH
- Physical Examination MeSH
- Humans MeSH
- Fluid Therapy * adverse effects MeSH
- Water-Electrolyte Balance MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
BACKGROUND: Since many acutely admitted older adults display signs of dehydration, treatment using balanced crystalloids is an important part of medical care. Additionally, many of these patients suffer from chronic malnutrition. We speculated that the early addition of glucose might ameliorate the hospital-related drop of caloric intake and modify their catabolic status. METHODS: We included patients 78 years and older, admitted acutely for non-traumatic illnesses. The patients were randomized into either receiving balanced crystalloid (PlasmaLyte; group P) or balanced crystalloid enriched with 100 g of glucose per liter (group G). The information about fluid balance and levels of minerals were collected longitudinally. RESULTS: In the G group, a significantly higher proportion of patients developed signs of refeeding syndrome, i.e., drops in phosphates, potassium and/or magnesium when compared to group P (83.3 vs. 16.7%, p < 0.01). The drop in phosphate levels was the most pronounced. The urinalysis showed no differences in the levels of these minerals in the urine, suggesting their uptake into the cells. There were no differences in the in-hospital mortality or in the 1-year mortality. CONCLUSION: The short-term administration of balanced crystalloids with glucose induced an anabolic shift of electrolytes in acutely admitted older adults.
- MeSH
- Dehydration therapy MeSH
- Glucose * metabolism administration & dosage MeSH
- Crystalloid Solutions administration & dosage MeSH
- Humans MeSH
- Hospital Mortality MeSH
- Dietary Supplements MeSH
- Refeeding Syndrome prevention & control MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Fluid Therapy * methods MeSH
- Water-Electrolyte Balance MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Dehydration etiology pathology therapy MeSH
- Enterobacteriaceae Infections * diagnosis etiology therapy MeSH
- Humans MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- MeSH
- Dehydration MeSH
- Hyponatremia etiology MeSH
- Water Intoxication * MeSH
- Humans MeSH
- Water physiology MeSH
- Check Tag
- Humans MeSH
Voda je hlavnou súčasťou vnútorného prostredia organizmu. Zdravotný stav človeka významne ovplyvňuje aj množstvo a kvalita tekutín, ktoré prijíma. Príjem a výdaj tekutín by mal byť za normálnych podmienok v rovnováhe. Ak straty tekutín výraznejšie presahujú ich príjem, môže dôjsť k dehydratácii. Nedostatok tekutín v organizme vzniká pri nesprávnom a nedostatočnom prísune, či nadmernej strate tekutín, čo môže spôsobiť problémy akútnej a chronickej povahy. Správny pitný režim, teda príjem a výdaj vody, je veľmi dôležitou podmienkou pre zachovanie optimálneho zdravotného stavu každého človeka.
Water is the main part of the internal environment of the organism. The state of health of each person is significantly influenced by the amount and quality of fluids they take in. Fluid intake and expenditure should under normal conditions be balanced. Significantly higher fluid expenditure than its intake can lead to dehydration. Lack of fluid in the organism can be caused by incorrect or insufficient fluid intake or excessive loss of fluids. This can lead to acute or chronic issues. Proper fluid regime (fluid intake and expenditure) is very important for the optimal state of health of every person.
- MeSH
- Dehydration * etiology therapy MeSH
- Organism Hydration Status MeSH
- Humans MeSH
- Palliative Care MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
