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The principle of rehydration therapy for children with acute Gastroenteritis 嬰幼兒急性腸胃炎及口服補液原則

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The principle of rehydration therapy for children with acute Gastroenteritis 嬰幼兒急性腸胃炎及口服補液原則

2024/1/15

The definition of pediatric diarrhea

Acute pediatric diarrhea is generally defined as

  • a decrease in the consistency of stools (loose or liquid )
  • and/or an increase in the frequency of evacuations (typically ≥ 3 in 24 hours).

However, a change in stool consistency versus previous stool consistency is more indicative of diarrhea than stool number, particularly in the first months of life.

If your child has diarrhea, assessing its severity; there are indications for a medical visit.

  1. Age <2 months
  2. Persistent vomiting
  3. High-output diarrhea with elevated stool volumes (>8 episodes/day)
  4. signs of severe dehydration

Dehydration is the consequence of diarrhea, vomiting, and fever. Therefore, estimate the degree of dehydration is important to avoid severe dehydration occurred.

The best parameter of dehydration are skin turgor, sunken eyes, mucous membrane and general appearance.

  • The dehydration sign including: Drowsy, limp, cool or sweaty general appearance, sunken eyes, tear absence and dry mucous membrane.

Principles and practices of oral rehydration therapy (ORS).

Oral rehydration therapy is the first line therapy for children with diarrhea.

  1. Infants younger than 6 months should neither interrupt breast-feeding nor introduce diluted or modified formula.
  2. Patients should continue to eat a normal diet or resume a normal diet once vomiting stops.
  3. Give small, frequent sips of ORS, measure the amount drunk, and the fluid lost as diarrhea and vomitus.
  4. Beverages with a high sugar content such as juice,soda, or sports drinks should not be used ,as they are relatively low in sodium and high osmolarity.

Recipe for Making a 1 liter ORS solution using Sugar, Salt and Water

If ORS is not available, you should provide water, broth, and/or other fluids. You can mix an oral rehydration solution by yourself using one of the following recipes.

  1. Clean Water - 1 liter - 5 cupfuls (each cup about 200 ml.)
  2. Sugar - Six level teaspoons
  3. Salt - Half level teaspoon

Stir the mixture till the sugar dissolves.

Assessment

Reassess the patient every 15–30 minutes and continue hydrating. The volumes and time intervals shown are guidelines provided on the basis of usual needs.

Fluid Replacement or Treatment Recommendations
Dehydration type
Treatment Recommendations
Some dehydration
Administer in first 4 hours:
All
ages
Volume of ORS
  1. 75 ml/kg in first 4 hours.
  2. Then reassess, and if patient still shows signs of dehydration, repeat the procedure above again
  3. If dehydration is relatively improved, use ORS to replace ongoing diarrheal losses.
  4. Use the treatment plan for no dehydration below.
No dehydration
Administer after each loose stool
Age
Volume of ORS
<2 years
50–100 ml
2–9years
100–200 ml
≥10 years
As much as patient wants

 

 

 

 

 

 

 

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