What should I do in case of electrolyte disturbances in a child with diarrhoea?
Knowing the levels of serum electrolytes rarely changes the management of children with diarrhoea. Indeed, these values are often misinterpreted, leading to inappropriate treatment. It is usually not helpful to measure serum electrolytes. The disorders described below are all adequately treated by ORT with ORS solution. Hypernatraemia Some children with diarrhoea develop hypernatraemic dehydration, especially when given drinks that are hypertonic owing to their content of sugar (e.g. soft drinks, commercial fruit drinks), some animal milks, or salt. These draw water from the child’s tissues and blood into the bowel, causing the concentration of sodium in extra-cellular fluid to rise. If the solute in the drink is not fully absorbed, the water remains in the bowel, causing osmotic diarrhoea. Children with hypernatraemic dehydration (serum Na+ >150 mmol/l) have thirst that is out of proportion to other signs of dehydration. Their most serious problem is convulsions, which usually occur w
Knowing the levels of serum electrolytes rarely changes the management of children with diarrhoea. Indeed, these values are often misinterpreted, leading to inappropriate treatment. It is usually not helpful to measure serum electrolytes. The disorders described below are all adequately treated by ORT with ORS solution. Hypernatraemia Some children with diarrhoea develop hypernatraemic dehydration, especially when given drinks that are hypertonic owing to their content of sugar (e.g. soft drinks, commercial fruit drinks) or salt. These draw water from the child’s tissues and blood into the bowel, causing the concentration of sodium in extra-cellular fluid to rise. If the solute in the drink is not fully absorbed, the water remains in the bowel, causing osmotic diarrhoea. Children with hypernatraemic dehydration (serum Na+ >150 mmol/l) have thirst that is out of proportion to other signs of dehydration. Their most serious problem is convulsions, which usually occur when the serum sodium
