Bushra Fatima, Muhammad Faheem Afzal, Muhammad Ashraf Sultan, Asif Hanif.
Biochemical types of dehydration and risk factors for sodium imbalance in children with acute watery diarrhea.
Pak Paed J Jan ;35(3):135-8.

Background: Acute watery diarrhea (AWD) is defined as passage of 3 or more loose stools/day or more frequent for the individual with duration of less than 14 days. Dehydration is biochemically categorized according to serum sodium concentration as isonatremic (135-145mEq/L), hyponatremic(<135mEq/L) and hypernatremic dehydration(>145mEq/L). Objective: To determine the biochemical types of dehydration and determine the risk factors for sodium imbalance in children with AWD. Study design: Cross sectional study. Setting: Department of Paediatrics Unit-I, King Edward Medical University/ Mayo Hospital, Lahore. Duration: March to August 2010. Subjects and Methods: A total of 500 children of age 1month-12 years with AWD were included in the study by non probability purposive sampling. After consent, demographica data was recorded. Each child was examined for degree of dehydration, and was investigated for serum sodium level. ANOVA was applied to find out the association of age and Chi square was applied to find out association of sex, feeding pattern, nutritional status, degrees of dehydration with type of dehydration. Each child was treated according to WHO plan of treatment for some or severe dehydration. Results: Mean age was 2.5±3 years. Clinically severe dehydration was found in most children (51%). Highest and lowest serum sodium level was 166 and 117 mEq/L respectively with mean of 134±6 mEq/L. Isonatremic dehydration was found in 51% children followed by hyponatremic dehydration (46%). There was positive association of nutritional status and degree of dehydration. (p value 0.05 each) More malnourished and more severely dehydrated the child was more was the chance of having sodium imbalance. Conclusion: Isonatremic dehydration is most common type of dehydration. Malnutrition and clinically severe dehydration are significantly associated with biochemical type of dehydration.

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