The Prevalence and Management of Dehydration amongst Neonatal Admissions to General Paediatric Wards in Kenya-A Clinical Audit

J Trop Pediatr. 2018 Dec 1;64(6):516-522. doi: 10.1093/tropej/fmx108.

Abstract

An audit of randomly selected case records of 810 patients admitted to 13 hospitals between December 2015 and November 2016 was done. Prevalence of dehydration was 19.7% (2293 of 11 636) [95% CI: 17.1-22.6%], range across hospitals was 9.4% to 27.0%. Most cases with dehydration were clinically diagnosed (82 of 153; 53.6%), followed by excessive weight loss (54 of 153; 35.3%) and abnormal urea/electrolytes/creatinine (23 of 153; 15.0%). Documentation of fluids prescribed was poor but, where data were available, Ringers lactate (30 of 153; 19.6%) and 10% dextrose (18 of 153; 11.8%) were mostly used. Only 17 of 153 (11.1%) children had bolus fluid prescription, and Ringer's lactate was most commonly used for bolus at a median volume per kilogram body weight of 20 ml/kg (interquartile range, 12-30 ml/kg). Neonatal dehydration is common, but current documentation may underestimate the burden. Heterogeneity in practice likely reflects the absence of guidelines that in turn reflects a lack of research informing practical treatment guidelines.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravenous
  • Child, Preschool
  • Dehydration / epidemiology*
  • Dehydration / physiopathology
  • Dehydration / therapy*
  • Female
  • Fluid Therapy / methods*
  • Hospitalization
  • Humans
  • Infant
  • Infant, Newborn
  • Isotonic Solutions / administration & dosage*
  • Isotonic Solutions / therapeutic use
  • Kenya / epidemiology
  • Male
  • Prevalence
  • Sodium Chloride / administration & dosage*
  • Sodium Chloride / therapeutic use
  • Treatment Outcome

Substances

  • Isotonic Solutions
  • Sodium Chloride