Page 76 - 15Diarrhoeaandvomiting

Assessing dehydration and shock

Proportion of children with elevated glucose N/A N/A N/A 13/119 (10.9%) (hyperglycaemia defined as >140 mg/dl) N/A

Proportion of children with serum bicarbonate concentration < normal 73/101 (72%) dehydrated children and 576/1047 (55%) children without without dehydration had a dehydration had a low bicarbonate concentration (low bicarbonate concentration defined as <21 mmol/l) Proportion of children not stated 4% of children had a low bicarbonate concentration (≤16 mmol/l) 13/76 (17.1%) (serum bicarbonate concentration <15 mmol/l) (lowest val

Proportion of children with urea concentration > normal 10/101 (30%) of dehydrated children and 56/1047 (5%) children raised urea concentration (raised urea concentration defined as >7 mmol/l) Proportion of children not stated 8% of children had raised serum urea concentration (>6 mmol/l) 17/76 (22%) (serum urea concentration >6 mmol/l) N/A 3/16 (19%) hypoglycaemic children had raised BUN 44/150 (29%) non- hypoglycaemic childre

Proportion of children with hypokalaemia N/A N/A N/A 5/119 (4.2%) (hypokalaemia defined as <3 mmol/l) N/A

Proportion of children with hyponatraemia N/A N/A 17/76 (22%) (serum sodium concentration within the range 128– 134 mmol/l) No definition of hyponatraemia given 4/119 (3.4%) (hyponatraemia defined as 1/119 (0.84%) had raised <130 mmol/l) N/A

Incidence of biochemical disturbances in children with gastroenteritis

Proportion of children Proportion of children with hypernatraemia with dehydration 8/1119 (0.71%) In total, 101/1148 (9%) were dehydrated, (hypernatraemia defined of which: as plasma sodium • 89/1148 (8%) were concentration of <5% dehydrated ≥150 mmol/l) • 11/1148 (1%) were 11/101 (11%) dehydrated 5–10% dehydrated children and 6/1047 • 1/1148 was >10% (0.57%) children without dehydrated dehydration had plasma sodium concentration o

Study reference Number and age of children n = 1148 Age range 0–10 years (37% were < 6 months and 82% were < 2 years) n = 447 admissions (21 re-admissions) made by 426 children younger than 2 years (75% were < 1 year) n = 215 Age range 2 weeks to 9 years (61% were < 1 year) n = 119 Age range 2 months to moderate dehydration 15 years n = 528 Data presented for 196/207 children with with dehydration acute gastroenteritis

Table 4.7 Conway et al. 53 Ellis et al. 57 Jenkins and Ansari 58 Yurdakok and Oran 79 Reid and Losek 80

51