Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- sede
- enchimento capilar >3 segundos
- turgor cutâneo diminuído
- membranas mucosas ressecadas
- estado mental ou nível de atividade anormal
- taquicardia
- débito urinário anormal
- frequência respiratória elevada ou respirações profundas
Other diagnostic factors
- vômitos
- diarreia
- dor abdominal
- resultado anormal na tira para teste de glicose
- temperatura central baixa ou febre
- pressão arterial (PA) anormal
- hematomas ou sinais de negligência
Risk factors
- vômitos e/ou diarreia
- idade <3 anos
- trauma
- queimaduras >10% da área de superfície corporal
- diabetes mellitus do tipo 1
- história de ingestão oral insatisfatória
- exercício intenso e prolongado
- história de uso de diuréticos
Diagnostic tests
1st tests to order
- diagnóstico clínico
Tests to consider
- eletrólitos séricos
- glicose sanguínea
- ureia/creatinina
- Hemograma completo
- urinálise
- densidade urinária
- osmolalidade urinária
- microscopia e cultura de urina
- hemocultura
- gasometria arterial
- ultrassonografia ou TC de crânio
- ultrassonografia abdominal ou tomografia computadorizada (TC)
Treatment algorithm
perdas entéricas
perdas hemorrágicas
perdas cutâneas
perdas renais
choque séptico
choque anafilático
Contributors
Authors
Katherine Mason, MD, FAAP
Vice Chair of Education, Department of Pediatrics
Associate Professor of Pediatrics
Brown University
Hasbro Children's Hospital
RI
Disclosures
KM declares that she has no competing interests.
Sarah Spencer Welsh, MD, FAAP
Medical Director
Pediatric Intensive Care Unit
Hasbro Children’s Hospital
Assistant Professor of Pediatrics
The Warren Alpert Medical School of Brown University
RI
Disclosures
SW declares that she has no competing interests.
Carly D. Schmidt, MD
Fellow in Pediatric Critical Care Medicine
C.S. Mott Children’s Hospital
University of Michigan
Ann Arbor
MI
Disclosures
CDS declares that she has no competing interests.
Acknowledgements
Dr Katherine Mason, Dr Sarah Welsh and Dr Carly D. Schmidt would like to gratefully acknowledge Dr Marla R. Carter, Dr Risha Moskalewicz, Dr Vincent J. Wang, Dr Naseem Sulayman, Dr Patricia Poitevien, and Anne Stormorken, previous contributors to this topic.
Disclosures
VJW is an author of a number of references cited in this topic. MC, RM, NS, PP and AS declare that they have no competing interests.
Peer reviewers
Jana A. Stockwell, MD, FAAP, FCCM
Assistant Professor of Pediatrics
Pediatric Critical Care Medicine
Emory University School of Medicine
Children's Healthcare of Atlanta
Atlanta
GA
Disclosures
JAS declares that she has no competing interests.
Joe Brierley, MD
Consultant Paediatric & Neonatal Intensive Care Unit
Great Ormond St Hospital for Children
London
UK
Declarações
JB is an author of a reference cited in this monograph.
Amber E.R. Young, BSc, MB ChB, FRCA
Consultant Paediatric Anaesthetist
Department of Anaesthesia
Frenchay Hospital
Bristol
UK
Declarações
AERY declares that she has no competing interests.
Akash Deep, MD, FRCPCH
Director
Paediatric Intensive Care Unit
King’s College Hospital
London
UK
Declarações
AD declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Glaser N, Fritsch M, Priyambada L, et al. ISPAD clinical practice consensus guidelines 2022: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2022 Nov;23(7):835-56. Resumo
World Health Organization. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: World Health Organization; 2005.
Weiss SL, Peters MJ, Alhazzani W, et al. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Intensive Care Med. 2020 Feb;46(suppl 1):10-67.Texto completo Resumo
Golden DBK, Wang J, Waserman S, et al. Anaphylaxis: a 2023 practice parameter update. Ann Allergy Asthma Immunol. 2024 Feb;132(2):124-76.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Differentials
- Desidratação
- Glomerulonefrite aguda
- Insuficiência adrenal
More DifferentialsGuidelines
- Anaphylaxis: a 2023 practice parameter update
- EAACI guidelines: anaphylaxis (2021 update)
More GuidelinesPatient information
Diarreia em crianças
Queimaduras (menores)
More Patient information
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