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.
Highlights
Neonatal dehydration may result from lactation failure associated with first-time motherhood, maternal illness, inadequate lactation support for mothers, early post-delivery discharge and incorrect use of formula feeds as well as neonatal illnesses [1,2,3,4,5,6,7,8]
We identified 153 cases with dehydration based on study criteria
Bolus was mostly given rapidly, 9 of 17 (52.9%), over 1–2 h in 5 of 17 (29.4) cases and with no information on two cases. This clinical audit was intended to investigate the prevalence and management of neonatal dehydration in neonates admitted to paediatric wards of 13 hospitals in Kenya
Summary
Neonatal dehydration may result from lactation failure associated with first-time motherhood, maternal illness, inadequate lactation support for mothers, early post-delivery discharge and incorrect use of formula feeds as well as neonatal illnesses [1,2,3,4,5,6,7,8] It may cause peripheral gangrene, convulsions, central venous and aortic thrombosis, coma and even death in the acute period; long-term neurodevelopmental abnormalities have been reported [9,10,11,12,13,14,15].
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