Dehydration in children
A lack of fluids that has grown over a long period of time can become an absolute emergency.
How high is the fluid requirement in children?
The daily fluid requirement in children is somewhat different from the daily fluid requirement in adults. This is because children have a significantly higher water turnover. The daily intake and release of fluids is around 10 - 20% of the body weight of an infant. Overall, a toddler can assume an average daily fluid requirement of 50-100 ml / kg body weight.
The amount of water contained in the food should also be taken into account separately in this calculation and included in the daily requirement. In most cases, the children drink according to their personal needs, as the brain constantly receives information about the current fluid balance via various receptors and can control the feeling of thirst. If a high fever, diarrhea, vomiting or profuse sweating occurs, the daily requirement increases as a lot of fluid is lost in these situations and has to be replenished in order to balance the fluid balance.
The most common cause is inflammatory gastrointestinal and diarrheal disease, which inevitably leads to a lack of fluids over a long period of time if the patient or parents do not actively counteract this. The cause of diarrhea in small children is usually inflammation of the gastrointestinal tract caused by viruses (30-50% rotaviruses), bacteria (salmonella, E.coli), parasites (amoeba lamblia), but the cause is not always known (30-50%) 50%). Rare causes of dehydration, also known as dehydration, can be: diabetes mellitus, diabetic insibitus, adrenogenital syndrome, Addison's disease, hypertrophic pyloric stenosis and various kidney diseases.
A loss of fluids is usually noticeable as a child's weight loss (child emergencies). A body weight loss of 5% is called a slight exicosis, with a 5-10% loss of one middle exicosis and with a weight loss of more than 10% of one severe exicosis. In addition, fluid loss is also associated with dryness of the skin (standing skin folds) and the mucous membranes and, in very severe cases, with marbled skin color, sunken fontanel, rapid pulse, low blood pressure, clouding and cramps. One distinguishes three types of dehydration, depending on the prevailing deficiency. If the child loses as much salt as water, one speaks of one isotonic dehydration (if vomiting or diarrhea). If more water than salt is lost, one speaks of one hypertonic dehydration (due to diarrhea, hyperventilation, decreased fluid intake and diabetes insibitus). Consequences e.g. one cholera, excessive sweating and increased salt loss can be a hypotonic dehydration (more salt than water is lost).
Depending on what form it is, the missing substance must be supplied to the body.
What are the consequences of a lack of fluids for my child?
The consequences of a lack of fluids in a child can be very diverse. Headaches, dry mucous membranes, sunken eyes and dry skin with standing skin folds can be the first signs of a lack of fluids. As the amount of fluid decreases, there is also an insufficient supply of the brain. The children appear listless, are no longer receptive and find it difficult to concentrate. Especially with infants, one should watch out for a sunken fontanel, very pale and partly marbled skin, as well as exhaustion and a greatly reduced urine output.
In addition to acute damage to kidney function, associated with an increasing urine concentration and rise in kidney values, possible consequences can also include racing heart, dizziness and a drop in blood pressure. In the event of severe fluid loss, shock symptoms can occur, which are associated with impaired consciousness, confusion and apathetic behavior and, in the worst case, can lead to a coma.
If the parents recognize the first signs of an acute lack of fluids, a pediatrician should be consulted and an immediate, balanced and slow fluid replacement initiated.