Dehydration Due to Diarrhoeal Illnesses : assessment in children

Diarrheal diseases are a significant global health issue, causing over one million deaths annually in patients over the age of 5. While the majority of cases can be effectively managed with oral rehydration solutions, severe dehydration requires intravenous fluid resuscitation.

A case-control study in Porto Alegre, Brazil, examined symptoms and signs in 192 children under two years to predict life-threatening dehydration from diarrhea. Key findings included:

• Sensitivity: Thirst (82%), six or more stools (71%), fever (60%), vomiting (58%), and loss of appetite (57%).
• Specificity: Blood in stools (97%), fever (78%), vomiting (78%).
• Predictive Value: Using fever or vomiting as criteria could select 24% of children with diarrhea, capturing about 60% of dehydration cases. Combining both symptoms increases detection to 75%.

Dehydration from diarrheal illnesses can manifest as isotonic, hypotonic, or hypertonic dehydration.

• Isotonic Dehydration: Occurs when water and electrolyte losses are balanced, resulting in no significant change in blood osmolarity. It is the most common type.
• Hypotonic Dehydration: Arises when more electrolytes than water are lost, leading to a decrease in blood osmolarity. This often results from diarrhea combined with inadequate sodium intake.
• Hypertonic Dehydration: Happens when water loss exceeds electrolyte loss, increasing blood...