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fluids and electrolytes in children

Robert Sümpelmann, Karin Becke, Sebastian Brenner, Christian Breschan, Christoph Eich, Claudia Höhne, Martin Jöhr, Franz-Josef Kretz, Gernot Marx, Lars Pape, Markus Schreiber, Jochen Strauss, Markus Weiss
This consensus- based S1 Guideline for perioperative infusion therapy in children is focused on safety and efficacy. The objective is to maintain or re-establish the child's normal physiological state (normovolemia, normal tissue perfusion, normal metabolic function, normal acid- base- electrolyte status). Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. A physiologically composed balanced isotonic electrolyte solution (BS) with 1-2...
October 17, 2016: Paediatric Anaesthesia
Jennifer G Jetton, Mark Sorenson
Both acute kidney injury (AKI) and chronic kidney disease (CKD) are seen more frequently in the neonatal intensive care unit (NICU) as advances in supportive care improve the survival of critically ill infants as well as those with severe, congenital kidney and urinary tract anomalies. Many aspects of the infant's care, including fluid balance, electrolyte and mineral homeostasis, acid-base balance, and growth and nutrition require close monitoring by and collaboration among neonatologists, nephrologists, dieticians, and pharmacologists...
October 6, 2016: Seminars in Fetal & Neonatal Medicine
Fredrick Ibinda, Hans-Christoph Zarnack, Charles R Newton
BACKGROUND: Perturbations of blood sodium are the most frequently encountered electrolyte disorder in sick children, and may influence fluid therapy. We examined the frequency of blood sodium perturbations, and factors and outcomes associated with hyponatremia in children admitted to a rural Kenyan hospital and investigated the risk factors associated with deaths in hyponatremic children. METHODS: Plasma sodium levels and other laboratory parameters were measured in children admitted to a rural Kenyan hospital...
2016: PloS One
Kamel S Kamel, Martin Schreiber, Ana P C P Carlotti, Mitchell L Halperin
Diabetic ketoacidosis (DKA), a common cause of severe metabolic acidosis, remains a life-threatening condition due to complications of both the disease and its treatment. This Acid-Base and Electrolyte Teaching Case discusses DKA management, emphasizing complications of treatment. Because cerebral edema is the most common cause of mortality and morbidity, especially in children with DKA, we emphasize its pathophysiology and implications for therapy. The risk for cerebral edema may be minimized by avoiding a bolus of insulin, excessive saline resuscitation, and a decrease in effective plasma osmolality early in treatment...
September 3, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Kazeem Olalekan, Andy Fox, Rodney Gilbert
BACKGROUND: Unlicensed medications are used all the time in the management of diseases in childhood. Tolvaptan (Jinarc®) is a vasopressin V2-receptor antagonist licensed for use to slow the progression of cyst development and renal insufficiency of ADPKD in adults with CKD stage 1 to 3 with evidence of rapidly progressing disease. Studies of animal models implicate the antidiuretic hormone arginine vasopressin and its messenger cyclic adenosine monophosphate (cAMP) as promoters of kidney-cyst cell proliferation and luminal fluid secretion...
September 2016: Archives of Disease in Childhood
Aleksandra Leligdowicz, William A Fischer, Timothy M Uyeki, Thomas E Fletcher, Neill K J Adhikari, Gina Portella, Francois Lamontagne, Christophe Clement, Shevin T Jacob, Lewis Rubinson, Abel Vanderschuren, Jan Hajek, Srinivas Murthy, Mauricio Ferri, Ian Crozier, Elhadj Ibrahima, Marie-Claire Lamah, John S Schieffelin, David Brett-Major, Daniel G Bausch, Nikki Shindo, Adrienne K Chan, Tim O'Dempsey, Sharmistha Mishra, Michael Jacobs, Stuart Dickson, G Marshall Lyon, Robert A Fowler
As of 20 May 2016 there have been 28,646 cases and 11,323 deaths resulting from the West African Ebola virus disease (EVD) outbreak reported to the World Health Organization. There continue to be sporadic flare-ups of EVD cases in West Africa.EVD presentation is nonspecific and characterized initially by onset of fatigue, myalgias, arthralgias, headache, and fever; this is followed several days later by anorexia, nausea, vomiting, diarrhea, and abdominal pain. Anorexia and gastrointestinal losses lead to dehydration, electrolyte abnormalities, and metabolic acidosis, and, in some patients, acute kidney injury...
2016: Critical Care: the Official Journal of the Critical Care Forum
Kentaro Ouchi, Kazuna Sugiyama
BACKGROUND: Reportedly, administration of hypotonic fluids containing 30.8-74 mEq/L sodium with 5 % glucose may lead to serious hyponatremia or hyperglycemia. In Japan, hypotonic fluids containing 90 mEq/L sodium with 2.6 % glucose are commonly used. We compared blood electrolyte balance and blood glucose concentration with the use of isotonic (140 mEq/L sodium with 1 % glucose) versus hypotonic fluids in pediatric patients. METHODS: We studied 77 children aged 5 months to 2 years who underwent oro-maxillofacial surgery and dental treatment under general anesthesia...
July 27, 2016: BMC Pediatrics
Huandan Yang, Bingbing Zhu, Ruifeng Zhang
Acute kidney injury (AKI) is characterized by the abrupt inability of the kidneys to adequately excrete waste products and regulate fluid and electrolyte homeostasis appropriately. This results in an at least partially reversible increase in the blood concentration of creatinine and nitrogenous waste products. Moreover, medication eliminated via renal routes will accumulate that in turn result in a "second hit" to the already injured kidneys. Furthermore, fluid management and nutrition will be hampered by oliguria...
July 21, 2016: Minerva Pediatrica
Pengpeng Xia, Xianchen Meng, Guoqiang Zhu
Enterotoxigenic Escherichia coli (ETEC) is the most common cause of diarrhea, which is a second leading cause of death for the children under five years old from all over the world. The key factors of ETEC contain both colonization factors (CFs) and enterotoxins including heat-labile enterotoxin (LT) and heat-stable enterotoxin (ST). CFs mediated the binding of bacteria to the host intestinal epithelial cells, whereas LT and ST stimulated the over-secretion of body fluids and electrolytes, resulting in the destruction of the host fluid balance and leading diarrhea...
February 4, 2016: Wei Sheng Wu Xue Bao, Acta Microbiologica Sinica
Anoush Azarfar, Yalda Ravanshad, Aghillolah Keykhosravi, Sepideh Bagheri, Ziaoddin Gharashi, Mohammad Esmaeeli
OBJECTIVES: The objective of this study is to evaluate the effect of rapid intravenous rehydration to resolve vomiting in children with acute gastroenteritis. METHODS: This randomized control trial was conducted in the pediatric emergency department in a tertiary care center in Tabriz, North-West of Iran. The study participants' were 150 children with acute gastroenteritis and vomiting who were moderately dehydrated, had not responded to oral rehydration therapy and without any electrolyte abnormalities...
September 2014: Turkish Journal of Emergency Medicine
Beth Vogt
Although kidney disease is much less common in children than in adults, clinicians must remain alert for the renal conditions that occur in this population because prompt diagnosis and management are essential. Acute postinfectious glomerulonephritis occurs as an uncommon sequela of streptococcal and other infections. Management is focused on providing supportive measures, including management of fluid-electrolyte imbalance and hypertension, until the patient recovers. Immunoglobulin (Ig) A nephropathy is a primary glomerulonephritis related to abnormal IgA glycosylation...
May 2016: FP Essentials
Stephen B Freedman, Andrew R Willan, Kathy Boutis, Suzanne Schuh
IMPORTANCE: Gastroenteritis is a common pediatric illness. Electrolyte maintenance solution is recommended to treat and prevent dehydration. Its advantage in minimally dehydrated children is unproven. OBJECTIVE: To determine if oral hydration with dilute apple juice/preferred fluids is noninferior to electrolyte maintenance solution in children with mild gastroenteritis. DESIGN, SETTING, AND PARTICIPANTS: Randomized, single-blind noninferiority trial conducted between the months of October and April during the years 2010 to 2015 in a tertiary care pediatric emergency department in Toronto, Ontario, Canada...
May 10, 2016: JAMA: the Journal of the American Medical Association
Özge Yüce, Umut Selda Bayrakçi, Kaan Gülleroğlu, Esra Baskın
INTRODUCTION: To investigate autonomic nervous system function in enuretic children by performing ambulatory blood pressure monitor (ABPM) for 24 h. METHODS: Twenty-eight children ranging in age from 6 to 15 years with primary nocturnal enuresis and 27 age-matched healthy controls were enrolled and they get 24 h ABPM. Hypertension was defined as standard deviation score (SDS) > 1.64 (i.e., >95th percentile) adjusted for gender and height. Urinalysis, urine electrolyte levels, urinary culture, and urinary system ultrasound were carried out in all children...
July 2016: Renal Failure
Urban Fläring, Kerstin Sandström, Krister Nilsson
Hyponatremia is the most frequent electrolyte abnormality seen postoperatively in pediatric patients receiving maintenance fluid therapy. Hyponatremia is also common in acute pediatric illness. The main factors contributing to hyponatremia in these conditions are increased secretion of antidiuretic hormone (ADH) and routine use of sodium hypotonic fluids. An increased ADH secretion results in an impaired ability to excrete free water. If the sodium concentration falls to less than 125 mmol/L hyponatremic encephalopathy might develop, resulting in cerebral edema...
2016: Läkartidningen
E A Krieger, O V Samodova, N N Gulakova, A B Aruiev, L A Krylova, L V Titova
Every year about 800,000 cases of intestinal infections end in lethal outcome due to dehydration. The different types of dehydration acquire differential approach to correction. Everywhere there is no application of routine detection of osmolarity of blood plasma under exicosis in children in view of absence of possibility of instrumental measurement. The search of techniques is needed to make it possible to indirectly detect types of dehydration in children hospitalized because of acute intestinal infection with purpose to apply rationale therapy of water-electrolyte disorders...
November 2015: Klinicheskaia Laboratornaia Diagnostika
Brian G A Dalton, Katherine W Gonzalez, Sushanth R Boda, Priscilla G Thomas, Ashley K Sherman, Shawn D St Peter
BACKGROUND: Hypertrophic pyloric stenosis (HPS) is the most common diagnosis requiring surgery in infants. Electrolytes are used as a marker of resuscitation for these patients prior to general anesthesia induction. Often multiple fluid boluses and electrolyte panels are needed, delaying operative intervention. We have attempted to predict the amount of IV fluid boluses needed for electrolyte correction based on initial values. METHODS: A single center retrospective review of all patients diagnosed with HPS from 2008 through 2014 was performed...
August 2016: Journal of Pediatric Surgery
Matthias Mariere Okposio, Alphonsus Ndidi Onyiriuka, Blessing Imuetiyan Abhulimhen-Iyoha
BACKGROUND/OBJECTIVE: Fluid, electrolytes and acid base disturbances are responsible for most deaths due to acute diarrhoea. The aim of this study is to describe the point-of-admission serum electrolyte profile of children with dehydration due to acute diarrhoea. METHODS: In this cross-sectional study, the serum electrolyte levels of 185 children with dehydration due to acute diarrhoea were assessed at the point of admission at the Diarrhoea Treatment and Training Unit of the University of Benin Teaching Hospital...
December 2015: Tropical Medicine and Health
Ashwani Kumar Sood, Lokesh Chauhan, Hemant Gupta
OBJECTIVE: To present the clinical, lab profile and outcome of a series of six children who had features of meningoencephalitis (median age of 10.5 y) diagnosed as confirmed scrub typhus (ST) by using a lgM ELISA commercial kit (InBiOS International Inc. USA). METHODS: This was a prospective observational study conducted at a tertiary care hospital, over a period of 7 mo through April 2014. All the patients with undifferentiated febrile illness (aged 1-18 y) with fever of 5-21 d duration were evaluated...
July 2016: Indian Journal of Pediatrics
Aadil Kakajiwala, Kathleen Chiotos, Julie Brothers, April Lederman, Sandra Amaral
INTRODUCTION: One of the greatest problems associated with continuous renal replacement therapy (CRRT) is the early clotting of filters. A literature search revealed three case reports of lipemic blood causing recurrent clotting and reduced CRRT circuit survival time in adult patients, but no reports of cases in children. DIAGNOSIS/TREATMENT: A 23-month-old male infant with Martinez-Frias syndrome and multivisceral transplant was admitted to the hospital with severe sepsis and hemolytic anemia...
January 27, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Simin Sadeghi-Bojd, Noor Mohammad Noori, Mehdi Mohammadi, Alireza Teimouri
BACKGROUND: Acute kidney injury (AKI) is characterized by a reversible increase in the blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. OBJECTIVE: AKI is a serious condition in critically ill patients. The aim of the study was to determine incidence rate, identify risk factors, and describe the clinical outcome of AKI in the Pediatric Intensive Care Unit (PICU)...
September 2015: Nigerian Medical Journal: Journal of the Nigeria Medical Association
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