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Pediatrics

Dehydration and electrolyte losses.
Risks, recommendations and treatments.

by Elisabetta Bocci

10.05.2024

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Article outline

  • Introduction

    • Presentation of the problem of dehydration and electrolyte loss.

    • Explanation of the link between these two phenomena.

    • Identification of the most vulnerable populations (children and the elderly).

  • Dehydration and loss of electrolytes:

       Understanding the phenomenon

  • What is dehydration?

    What are electrolytes and why are they important?

  • Relationship between dehydration and electrolyte loss.

  • Risks for children

    • Why are children more vulnerable?

    • Symptoms and complications in children.

    • WHO recommendations for prevention and treatment.

  • Risks for the elderly

    • Specific risk factors in the elderly.

    • Symptoms and complications in the elderly.

    • WHO recommendations for prevention and treatment.

  • Conclusion

    • A reminder of the importance of prevention and treatment.

    • Call to raise awareness among vulnerable populations.

1. Introduction

Dehydration, accompanied by electrolyte loss, is a major public health problem, particularly affecting children and the elderly. This phenomenon occurs when the body loses more fluids than it absorbs, thus upsetting the water and electrolyte balance. Electrolytes, such as sodium, potassium, calcium and magnesium, are essential for many bodily functions, including the regulation of acid-base balance, nerve conduction and muscle contraction. Dehydration can lead to serious complications, such as convulsions, hypovolemic shock and even death.

 

In children, dehydration is often caused by episodes of acute diarrhea, vomiting or high fever, while in the elderly, it is often the result of a combination of factors such as reduced sensation of thirst, chronic illness and the use of certain medications.

 

This article explores in detail the risks of dehydration and electrolyte loss in these vulnerable populations, focusing on symptoms, potential complications and prevention and treatment strategies.

2. Dehydration and electrolyte loss:

Understanding the phenomenon

What is dehydration?

Dehydration occurs when the body loses more water than it absorbs. This may be due to excessive sweating, vomiting, diarrhea or low fluid intake. Water loss leads to a reduction in blood volume, which disrupts circulation and the transport of essential nutrients to the cells.

 

What are electrolytes and why are they important?

Electrolytes are minerals found in blood, urine, tissues and other body fluids.

The main electrolytes include :

  • Sodium (Na+) : Régule l'équilibre hydrique et la pression sanguine.

  • Potassium (K+) : Essentiel pour la fonction cardiaque et la contraction musculaire.

  • Calcium (Ca2+) : Important pour la coagulation sanguine et la santé osseuse.

  • Magnésium (Mg2+) : Joue un rôle dans les fonctions nerveuses et musculaires.

 

When the body loses fluids through perspiration, vomiting or diarrhoea, it also loses electrolytes. This can lead to electrolyte imbalance, disrupting normal bodily functions. For example, low sodium levels (hyponatremia) can cause nausea, headaches and, in severe cases, convulsions.

3. Risks for children

  • Why are children more vulnerable? Children are particularly susceptible to dehydration for several reasons:

  • Their metabolism is faster, which means they lose water more quickly.

  • They depend on adults for access to fluids and may not express their thirst.

  • They are more likely to suffer from diarrhea or vomiting linked to gastrointestinal infections.

  • Symptoms and complications in children Symptoms of dehydration in children include:

  • Dry mouth

  • Absence of tears when crying

  • Infrequent or dark urine

  • Fatigue, irritability

  • Sunken eyes, sunken fontanel in infants

  • Possible complications include:

  • Electrolyte imbalance

  • Convulsions

  • Hypovolemic shock

  • WHO recommendations for prevention and treatment The World Health Organization (WHO) recommends the following measures to prevent and treat dehydration in children:

  • Prevention :

    • Encourage regular water consumption.

    • Use oral rehydration solutions (ORS) in case of diarrhea.

    • Limit caffeinated and sugary drinks.

  • Processing :

    • Administer ORS to restore fluid and electrolyte balance.

    • ORS should contain approximately 75 mmol/L sodium and 75 mmol/L glucose, in line with WHO recommendations.

    • Continue normal feeding during and after the episode of diarrhea to ensure rapid nutritional recovery.

    • Consult a healthcare professional in the event of severe symptoms.

4. Risks for the elderly

Specific risk factors in the elderly The elderly are also at risk of dehydration for several reasons:

  • Reduced sensation of thirst.

  • Mobility problems limiting access to fluids.

  • Use of diuretic drugs.

  • Chronic illnesses such as diabetes.

Symptoms and complications in the elderly Symptoms in the elderly can be more subtle, including:

  • Mental confusion

  • Dizziness

  • Dark or infrequent urine

  • Fatigue, weakness

Potential complications include:

  • Renal insufficiency

  • Urinary tract infections

  • Electrolyte imbalance

  • Hypovolemic shock

WHO recommendations for prevention and treatment The WHO proposes the following recommendations for the elderly:

  • Prevention :

    • Encourage regular hydration, even when you don't feel thirsty.

    • Limit alcohol and caffeine.

    • Monitor fluid intake in people with chronic illnesses.

    • Train caregivers to recognize signs of dehydration.

  • Processing :

    • Oral rehydration solutions.

    • ORS must contain optimal concentrations of electrolytes to meet the specific needs of the elderly.

    • Hospitalization for intravenous rehydration in severe cases.

5. Conclusion

Dehydration and electrolyte loss are serious threats to the health of children in particular, as well as the elderly. Awareness of the symptoms and risk factors, and the implementation of effective preventive measures, are essential to reduce the impact of these problems. By raising awareness among families and healthcare professionals, we can ensure better care for these vulnerable populations and reduce the complications associated with dehydration.

The WHO encourages this implementation and proposes balanced fluid compositions adapted to prevent the loss of body fluids and electrolytes. However, the quality of the water used to reconstitute powders and elements must be taken into account on a regular basis. With a ready-to-drink solution, this problem of unsafe water is solved. A very practical preparation for long-distance travel.

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