Dehydration in Children with Respiratory Tract Infections in a PediatricEmergency Department of a Tertiary Hospital

Abstract

Backgrounds: Dehydration is a common finding the Emergency Department(ED). The main cause of dehydration in the pediatric population is acute gastroenteritis, but it can be present with other illness such as respiratory infections. The aim of this study was to determine the prevalence of dehydration in patients presenting with lower respiratory tract infection (LRTI).

Methods: Prospective observational study of patients with LRTI admitted in the ED in a period of three-months. Patients with LRTI were included and assessed with the Clinical Dehydration Scale (CDS) to determine clinical dehydration. Patients were weighted on admission and 24-hours after admission to determine weight change after
fluid management.

Results: 88 patients with LRTI were included. A total of 23(26.1%) patients presented a degree of dehydration according to the CDS scale. Comparing weight changed on admission and 24-hours later 55.6% had an increased weight. When comparing the grade of dehydration with the CDS scale vs increased weight changed at 24-hours after fluid management, it was statically significant for patients 6 months-1 year(23% vs 64%;p value 0.01), 1-2 years(25% vs 50%;p value 0.05) and >2 years(16% vs 50%;p value 0.03). The most common clinical finding was mild dehydration in 22 patients and moderate/severe in only 1 patient.

Conclusions: This is one of the few studies of dehydration in illness not related to gastroenteritis. The key finding of this study was that LRTI in some of the patients were associated with certain degree of dehydration. Not all patients with dehydration were detected using clinical findings and this difference was found using weight changed.