Volume depletion in children

Children with mild volume depletion are frequently best managed at home. Carers need to have access to appropriate rehydration therapy and be able to monitor the child's condition closely. They require education to look for signs that the child may not be responding appropriately to therapy or has new symptoms. They also need the resources necessary to return for further health care if needed. Parents should be instructed to monitor volume and frequency of vomiting, diarrhoea, and urine output, and general appearance and condition of the child. They should look out for new signs or symptoms that should prompt repeat consultation.

Inpatient therapy, particularly for children with severe volume depletion, requires close monitoring of the child's clinical condition (e.g., mental state, haemodynamic indices). Volumes of fluid intake and output are recorded. Managing children with diabetic ketoacidosis may follow specialist protocols for monitoring electrolytes and blood glucose. Patients ill enough to require intravenous hydration may require a basic chemistry screen and electrolyte monitoring during therapy. Whenever hypotonic fluids are delivered, frequent monitoring of electrolytes to ensure detection of rapid changes in serum sodium is recommended. Patients with septic shock may require advanced monitoring in the intensive care unit.