Department of Pediatrics, Maasstad Hospital, P.O. Box 9100, 3075 EA, Rotterdam, The Netherlands.
Eur J Pediatr. 2010 Jul;169(7):883-6. doi: 10.1007/s00431-010-1140-8. Epub 2010 Feb 2.
Acute gastroenteritis is common in childhood. The estimation of the degree of dehydration is essential for management of acute gastroenteritis. Plasma water was assessed as a diagnostic tool in children with acute gastroenteritis and dehydration admitted to hospital. In a prospective cohort study, 101 patients presenting at the emergency department with dehydration were included. Clinical assessment, routine laboratory tests, and plasma water measurement were performed. Plasma water was measured as a percentage of water content using dry weight method. During admission, patients were rehydrated in 12 h. Weight gain at the end of the rehydration period and 2 weeks thereafter was used to determine the percentage of weight loss as a gold standard for the severity of dehydration. Clinical assessment of dehydration was not significantly associated with the percentage of weight loss. Blood urea nitrogen (r = 0.3, p = 0.03), base excess (r =-0.31, p = 0.03), and serum bicarbonate (r = 0.32, p = 0.02) were significantly correlated with the percentage of weight loss. Plasma water did not correlate with the percentage of weight loss. On the basis of the presented data, plasma water should not be used as a diagnostic tool in the assessment of dehydration in children with acute gastroenteritis.
急性肠胃炎在儿童中很常见。评估脱水程度对于急性肠胃炎的治疗至关重要。我们评估了血浆水作为诊断工具在急性肠胃炎和脱水住院儿童中的作用。在一项前瞻性队列研究中,纳入了 101 名因脱水而在急诊就诊的患者。进行了临床评估、常规实验室检查和血浆水测量。使用干重法测量血浆水作为水含量的百分比。在入院期间,患者在 12 小时内接受补液。补液结束时和之后 2 周的体重增加用于确定体重减轻的百分比,作为脱水严重程度的金标准。脱水的临床评估与体重减轻的百分比无显著相关性。血尿素氮 (r = 0.3,p = 0.03)、碱剩余 (r =-0.31,p = 0.03) 和血清碳酸氢盐 (r = 0.32,p = 0.02) 与体重减轻的百分比显著相关。血浆水与体重减轻的百分比无相关性。根据所提供的数据,血浆水不应作为评估儿童急性肠胃炎脱水的诊断工具。