Abstract:Our objective was to determine the ability of several clinical signs of dehydration to distinguish among degrees of dehydration in infants with acute diarrhea. The design was a prospective cohort study in a pediatric referral hospital in Cairo, Egypt. Infant boys, 3-18 months old, with a history of acute diarrhea (5 or more watery stools per day for no more than 7 days) were eligible, except those with frank protein-energy malnutrition, serious nongastrointestinal illness, or being exclusively breast-fed. Seve… Show more
“…The clinical signs of dehydration are variable; 30 the degree of dehydration is most accurately predicted with a combination of the observer's experience, 31,32 the measured acute weight loss, and the presence of metabolic acidosis. 33 Placed together, these allow an assessment of whether dehydration is mild, moderate or severe.…”
Section: Acute Gastroenteritis: What Are the Problems?mentioning
“…The clinical signs of dehydration are variable; 30 the degree of dehydration is most accurately predicted with a combination of the observer's experience, 31,32 the measured acute weight loss, and the presence of metabolic acidosis. 33 Placed together, these allow an assessment of whether dehydration is mild, moderate or severe.…”
Section: Acute Gastroenteritis: What Are the Problems?mentioning
“…It is especially difficult to distinguish between mild and moderate dehydration because the first signs of dehydration appear at 3-4% dehydration, increase at 5% (the threshold for mild dehydration), and there is not another significant clinical difference until 9 -10% (the threshold for severe) (7,16). Overall, the ability of clinical signs to predict the degree of dehydration (mild, moderate, or severe) is, at best, problematic.…”
Section: Assessing Dehydration and The Role Of Laboratory Studiesmentioning
“…It may be most useful if normal, as this does seem to exclude reliably severe dehydration. In a prospective cohort study of dehydrated children between 3 and 18 months of age, the best correlation between clinical assessment of degree of dehydration and actual volume depletion came in children who had obvious clinical parameters of significant dehydration such as prolonged skinfold tenting, a dry mouth, sunken eyes, and altered sensorium [86]. Similarly, in a review of preschool children with dehydration, the best clinical indicators of volume depletion -decreased skin turgor, poor peripheral perfusion, and Kussmaul breathing -accompanied more significant dehydration where there was little clinical question of volume depletion [87].…”
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