Enteropathogens, feeding practices and biochemical disturbances in diarrheal dehydration
Mittal, S.K.; Kanwar, A.; Saluja, S.; Nakra, S.
Indian Pediatrics 24(11): 999-1005
1987
ISSN/ISBN: 0019-6061 PMID: 2836310 Document Number: 287933
One hundred thirty five infants hospitalized with acute diarrheal illness were investigated for biochemical disturbances to define the inter-relationship of feeding practices, enteropathogens, host nutritional status and biochemical disturbances. Bacteriological and virological studies (for Rota virus) were done and admission levels of serum sodium, potassium and blood urea nitrogen were obtained in each case. The majority of infants had hyponatremic (serum sodium < 130 mEq/litre) dehydration. None had hypernatremic dehydration. The mean serum sodium level in purely breast fed dehydrated infants (128.33 .+-. 3.72 mEq/litre) was identical to that in top (126.49 .+-. 4.65 mEq/litre) or mixed fed (129.13 .+-. 4.85 mEq/litre) infants, and so also the serum potassium and blood urea values. The most important single determinant of serum sodium levels was the nutritional status of the child. The serum sodium levels of 123.34 .+-. 1.30 in severely malnourished children was significantly lower than those in normally nourished (130.4 .+-. 1.64) and that in subclinically malnourished (128.8 .+-. 0.89). Where malnutrition prevails, hyponatremia and hypokalemia are the principle biochemical disturbances in acute diarrheal dehydration. The practice of diluting top milk may further compound the occurrence of hyponatremic dehydration.