TABLE 1282 Estimation of Dehydration

It is important to realize that assessing the degree of dehydration in very young infants is notoriously difficult, and fluid losses are often underestimated. LABORATORY FINDINGS

In isotonic dehydration, the sodium level is within normal range. The potassium level is usually normal or slightly decreased. The serum bicarbonate level is often decreased: in mild dehydration it is usually in the range of 15 to 20 meq/L, whereas in more severe cases it falls below 10 meq/L. A low serum bicarbonate level reflects stool losses, the presence of ketones from "starvation," and in severe dehydration lactic acidosis. The blood urea nitrogen level usually rises with increasingly severe fluid losses. Urine specific gravity also rises in significant dehydration and may reach 1.030. In young infants, a decreased ability to concentrate urine may result in a falsely low specific gravity. It is not necessary to check the electrolyte level of patients who are mildly dehydrated. 3

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