Plasma water as a diagnostic tool in the assessment of dehydration in children with acute gastroenteritis

Plaisier, Annemarie; Groof, Femke Maingay-de; Mast-Harwig, Roechama; Kalkman, Patricia M. J.; Wulkan, R. W.; Verwers, Renee; Neele, Marjolein; Hop, Wim C. J.; Groeneweg, Michael

doi:10.1007/s00431-010-1140-8

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…The presented series of a different group of patients confirms our previous observation in a separate group of infants. In clinical practice, negative BE values and lowering of bicarbonate due to dehydration are typical for infants with nonsurgical vomiting due to gastroenteritis or infection [11]. However, in concordance with our pilot series, negative BE occurs in approximately 9% of infants with IHPS.…”

Section: Discussionsupporting

confidence: 87%

Pyloric Stenosis and Nonbilious Vomiting in Infants: Negative Base Excess and Hypercapnia—Two Opposing Points of One Scale a Comparative Case Series

Tröbs¹,

Baranski²,

Lipphaus³

et al. 2023

OJPed

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Background: Blood pH and bicarbonate estimations are basal acid-base laboratory tests that are performed in infants with infantile hypertrophic pyloric stenosis (IHPS). This study aimed to define the clinical value of pCO 2 and BE in infants suspected to have IHPS. Methods: We collected data from 80 "surgical" infants younger than 100 days with prolonged nonbilious vomiting who were suspected to have IHPS. In 65 infants, pyloric stenosis was confirmed, and 15 infants had nonsurgical conditions. Capillary blood was tested for standard acid-base parameters and lactate. The two groups were compared. Results: Eighty-eight percent of the IHPS infants had elevated standard bicarbonate levels (st bicarb) > 25 mmol/l, and 60% had BE > 3.5 mmol/l; 12% of the infants showed hypercapnia (pCO 2 ≥ 50 mmHg) associated with markedly increased standard bicarbonate and BE. Infants with nonsurgical vomiting were older at admission (p = 0.002), had a longer duration of vomiting (p < 0.001), were older (p = 0.002) and weighted more at admission (p = 0.004), had lower pCO 2 (p = 0.021), lower st bicarb (p < 0.001) and lower BE (p = 0.001). In addition, nonsurgical infants showed a trend to anemia (p = 0.002). Conclusions: In infants with IHPS/nonbilious vomiting, acid-base analysis (ABA) is equivocal or inconclusive. These findings may be misleading and could result in a false clinical decision. Nonsurgical vomiting is associated with a lower degree of alkalosis, normocapnia to slight hypercapnia and a base deficit. However, even infants with IHPS may present with a negative BE. In infants with IHPS and severe alkalosis, hypercapnia carries a risk for respiratory depression. Monitoring the infant's respi-

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Section: Discussionsupporting

confidence: 87%

Pyloric Stenosis and Nonbilious Vomiting in Infants: Negative Base Excess and Hypercapnia—Two Opposing Points of One Scale a Comparative Case Series

Tröbs¹,

Baranski²,

Lipphaus³

et al. 2023

OJPed

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“…The percent of water in each pre-mixed beverage was ascertained using the thermogravimetric method based upon previously establish protocols in biological samples [26,27]. Briefly, 2 mL of each beverage was carefully weighed in an evaporation dish.…”

Section: Methodsmentioning

confidence: 99%

Osmolality of Commercially Available Oral Rehydration Solutions: Impact of Brand, Storage Time, and Temperature

Sollanek

Kenefick

Cheuvront³

2019

Nutrients

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Oral rehydration solutions (ORS) are specifically formulated with an osmolality to optimize fluid absorption. However, it is unclear how many ORS products comply with current World Health Organization (WHO) osmolality guidelines and the osmotic shelf-life stability is not known. Therefore, the purpose of this investigation was to examine the within and between ORS product osmolality variation in both pre-mixed and reconstituted powders. Additionally, the osmotic stability was examined over time. The osmolality of five different pre-mixed solutions and six powdered ORS products were measured. Pre-mixed solutions were stored at room temperatures and elevated temperatures (31 °C) for two months to examine osmotic shelf stability. Results demonstrated that only one pre-mixed ORS product was in compliance with the current guidelines both before and after the prolonged storage. Five of the six powdered ORS products were in compliance with minimal inter-packet variation observed within the given formulations. This investigation demonstrates that many commercially available pre-mixed ORS products do not currently adhere to the WHO recommended osmolality guidelines. Additionally, due to the presence of particular sugars and possibly other ingredients, the shelf-life stability of osmolality for certain ORS products may be questioned. These findings should be carefully considered in the design of future ORS products.

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“…Search terms and Mesh terms used in the literature search for R1; Table S2. Search terms and Mesh terms used in the literature search for R2; Supplementary Table S3: Main characteristics and conclusions of studies included in the ScR-2; Supplementary File S2: Risk of bias [81][82][83][84][85][86][87][88][89]. Funding: This research was funded by an educational grant from Nestlé Health Science (Switzerland) and Fundació Salut del Consorci Sanitari del Maresme, Strategic Plan for Research and Innovation in Health (PERIS), Generalitat de Catalunya (intensification grant of Alicia Costa; SLT017/20/000220).…”

Section: Supplementary Materialsmentioning

confidence: 99%

The Hydration Status of Adult Patients with Oropharyngeal Dysphagia and the Effect of Thickened Fluid Therapy on Fluid Intake and Hydration: Results of Two Parallel Systematic and Scoping Reviews

et al. 2022

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Background: The effect of oropharyngeal dysphagia (OD) and thickened fluid (TF) therapy on hydration status has not been well defined in the literature. We aimed to assess the hydration status in patients with OD and the effect TF therapy has on it. Methods: Two literature reviews following PRISMA methodology (each one including a systematic and a scoping review) were performed: (R1) hydration status in adult patients with OD; (R2) effect of TF therapy on fluid intake and dehydration. Narrative and descriptive methods summarized both reviews. Quality assessment was assessed by Joanna Briggs Institute tools and GRADE. Results: (R1) Five out of twenty-two studies using analytical parameters or bioimpedance showed poorer hydration status among OD and 19–100% prevalence of dehydration; (R2) two high quality studies (total of 724 participants) showed positive effects of TF on hydration status. Among the articles included, nine out of ten studies that evaluated fluid intake reported a reduced TF intake below basal water requirements. Conclusions: Dehydration is a highly prevalent complication in OD. There is scientific evidence on the positive effect of TF therapy on the hydration status of patients with OD. However, strict monitoring of fluid volume intake is essential due to the low consumption of TF in these patients.

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Plasma water as a diagnostic tool in the assessment of dehydration in children with acute gastroenteritis

Cited by 6 publications

References 15 publications

Pyloric Stenosis and Nonbilious Vomiting in Infants: Negative Base Excess and Hypercapnia—Two Opposing Points of One Scale a Comparative Case Series

Pyloric Stenosis and Nonbilious Vomiting in Infants: Negative Base Excess and Hypercapnia—Two Opposing Points of One Scale a Comparative Case Series

Osmolality of Commercially Available Oral Rehydration Solutions: Impact of Brand, Storage Time, and Temperature

The Hydration Status of Adult Patients with Oropharyngeal Dysphagia and the Effect of Thickened Fluid Therapy on Fluid Intake and Hydration: Results of Two Parallel Systematic and Scoping Reviews

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