An article published in Emergency Medicine Clinics of North America aimed to discuss evidence-based treatment of dehydration due to acute gastroenteritis in children.

The authors stated that many other common childhood illnesses, such as bronchiolitis, influenza, gingivostomatitis and urinary tract infections, may cause dehydration. Some of these other ailments require specific therapy, yet, the approach to associated dehydration is generally similar.

Treatment considerations of diarrhea and dehydration vary based on health care resources, incidence of preexisting poor nutrition and common pathogens. Children with dehydration are divided into severity subgroups by percent of weight lost during the illness. Minimal or no dehydration is defined as a loss of less than 3% of body weight; mild dehydration is a 3-5% loss; moderate dehydration is a 6-9% loss; and severe dehydration is a loss of 10% or more of the pre-illness weight. However, the degree of pediatric dehydration may be difficult to clinically quantify.

This article informed that dehydration may be treated with oral, subcutaneous or intravenous fluids. Most children with mild to moderate dehydration can be successfully managed with oral rehydration. When intravenous fluids are chosen for rehydration, isotonic solutions should be used to avoid iatrogenic hyponatremia.

Source: Emergency Medicine Clinics of North America. 36 (2018) 259-273. https://doi.org/10.1016/j.emc.2017.12.004