Assessment of hydration in diarrhoea

Accurate assessment of the dehydration status remains a crucial step in the management of diarrhoea (1). Underestimating the fluid deficiency may lead to acidosis, electrolyte disturbances, acute kidney injury, or even death while overestimating may cause unnecessary interventions, longer hospital stays, and increased adverse events in children (1).

The following scales are commonly used to estimate dehydration status using clinical signs:

• WHO scale
• Gorelick scale - created at the Children's Hospital of Philadelphia
• the clinical dehydration scale (CDS) - created at the Hospital for Sick Children in Toronto

Each scale also predicts a slightly different range for percent volume loss (1).

Note:

• it should be noted that all 3 clinical dehydration scales used in a resource-limited setting, were not accurate predictors of severe dehydration in children with diarrhea and/or vomiting (1)

Reference:

• (1) Pringle K et al.Comparing the accuracy of the three popular clinical dehydration scales in children with diarrhea. Int J Emerg Med. 2011;4:58