Dehydration in pediatrics can be caused by vomiting, diarrhea, diabetes, or other conditions. It is classified as mild, moderate, or severe based on the percentage of fluid loss. Signs include irritability, sunken eyes, dry mouth, and decreased urine output. Treatment involves oral rehydration for mild cases and intravenous fluids for moderate or severe dehydration. The amount and duration of intravenous fluids depends on the degree of dehydration and sodium levels, with the goal of replacing fluid deficits and ongoing losses over 24 hours or more for severe cases. Complications can include shock, electrolyte imbalances, renal failure, seizures, and brain edema.

1. SAWA'EDTEAM @RaedRayani
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DehydrationInPediatrics
# Outlines :
- Definition .
- Causes.
- Classification .
- Investigations .
- Management .

2. SAWA'EDTEAM @RaedRayani
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# Definition :
LossOf Body Fluid Due To :
- Output.
- Intake.
# Causes:
- Vomiting .
- Diarrhea .
- DKA.
- Diabetes Insipidus .
- Congenital Adrenal Hyperplasia .
- Oral Ulcer .
# DegreeOfDehydration :
- LossOf1 kg = Loss Of1 Litter .
# Classification :
- Mild Loss Of 3-5% Of Volume .
- Moderate Loss Of 6-9% Of Volume.
- Sever Loss Of >10% Of Volume.

3. SAWA'EDTEAM @RaedRayani
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- HxOf Reduction Of Urine .
- SignsMaybeAbsent .
# Signs:
- Irritable .
- Slow Skin Turgor < 2 sec.
- Sunken Eyes AndDepressed Fontanel .
- Dry Mucous Membrane .
- Eagar ToDrink.
- Tearing & UrineOutput
- Delay Capillary Refill
# Signs:
- Lethargy .
- Hypotension & Cold Extremities .
- UnableTo Drink .
- Slow Skin Turgor > 2 sec.
- Respiratory Rate( RR )+Deep Respiration .
- Sunken Eyes & DepressedFontanel .
Moderate Dehydration
Severe Dehydration
Mild Dehydration

4. SAWA'EDTEAM @RaedRayani
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# Comparison :
Mild Moderate Severe
General Alert Irritable Lethargic& Shocked
Eyes Not Sunken Sunken Very Sunken
Drinking Normal Eagerly Unable
Skin Turgor GoBack Rapidly Slow < 2 sec. Very Slow > 2 sec.
# Investigations :
- Electrolytes (Mainly Na+ , K+ ).
- UrineNa+ .
- UrineOsmolarity & SpecificGravity .
- Search For Underlying Condition ( Such As Stool Analysis ).
# Treatment :
1- Mild Dehydration :
- TreatedWith ORS .

5. SAWA'EDTEAM @RaedRayani
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2- Moderate Dehydration :
A- Deficit 75 X Weight .
B- Maintenance:
- 1st 10 kg Weight X 100 .
- 2nd 10 kg Weight X 50 .
- More Than 20 kg Weight X 20 .
C- Ongoing Loss 10 X Weight .
# How IsGiven ?
- Give ORS Over 4 - 6 Hours .
- Or Give IV (Deficit +Maintenance ) As TheFollowing :
In Constant Rate Over 24 Hours.
Or 𝟏
𝟐⁄ Amount Over 8 Hours & The Rest Over 16 Hours .
# Note :
- Use D5% 𝟏
𝟐⁄ Normal Saline ( NS ) .
Deficit + Maintenance + Ongoing Loss

6. SAWA'EDTEAM @RaedRayani
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3- Sever Dehydration :
A- Bolus 20 X Weight .
B- Deficit 100 X Weight .
C- Maintenance :
- 1st 10 kg Weight X 100 .
- 2nd 10 kg Weight X 50 .
- More Than 20 kg Weight X 20 .
D- Ongoing Loss 10 X Weight .
# Rehydration Duration Is Depend On Na+ Level :
- Isonatremia Na+ =130 -150 mEq/L .
- Hyponatremia Na+ <130 mEq/L .
- Hypernatremia Na+ >150 mEq/L
 IfNa+ =158 – 170 mEq/L Rehydration For 2 Days ( Maintenance X 2 ) .
 IfNa+ =171 - 183 mEq/L Rehydration For 3 Days ( Maintenance X 3 ) .
# Note :
- Bolus Use Normal Saline ( NS ) .
- Total Use D5% 𝟏
𝟐⁄ NS .
( Deficit + Maintenance + Ongoing Loss ) - Bolus
Rehydration Over
24 Hours

7. SAWA'EDTEAM @RaedRayani
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# Severely Dehydrated Child DevelopedHypoglycemia :
- Manage SameAs Severe Dehydration +2.5 ml/kg D10% Bolus Over 30 min.
# ChildIn Shock:
Give20 ml/kg NS ,Then Check Peripheral Pulse :
- If NoPulse Repeat …
- If NoPulse Repeat …
- If No Response You Have To Consider Other Cause OfShock ( SepticShock ).
# Note :
- Give3 Times (Up To60 ml/kg NS) .
# Complications OfDehydration :
- Shock .
- Electrolyte Imbalance .
- Renal Failure.
- Seizures.
- Brain Edema .
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