[Children hospitalized with acute gastro-enteritis. I. Electrolyte imbalances seen primarily in clinical dehydration].

OBJECTIVE

To determine how often electrolyte disturbances occurred in children with acute diarrhoea and whether these findings had therapeutic consequences.

DESIGN

Retrospective.

METHOD: The hospital records of 265 children (152 boys and 113 girls; mean age: 1 year and 9 months (range: 1 month-12 years)) admitted with acute diarrhoea during the period 1992-1996 to the department of Paediatrics of Sint Joseph Ziekenhuis, Veldhoven, the Netherlands, were examined for abnormal laboratory values of Na, K, urea, creatinine and base excess. It was also determined if dehydration was present and if the findings affected the treatment. The therapeutic protocol included administration of a rehydration fluid if the child did not drink well; the own nutrition was resumed after 4-6 hr.

RESULTS

74 of the children admitted (28%) were clinically dehydrated. Abnormal laboratory values were found mainly (38/47) among these children. The majority (68; 92%) had isonatraemic dehydration. Most of the abnormal laboratory values normalised after rehydration. Only in the one case of hypokalaemia did this lead to a change in the composition of the rehydration fluid.

CONCLUSION

Routine determination of electrolytes, urea, creatinine and blood gas is not necessary in all children with acute diarrhoea. These laboratory measures should be restricted to dehydrated children. Even then abnormal laboratory values are few and seldom have therapeutic consequences.