Lab Case 191

4 month old female (corrected age 4 weeks) presents to ED after a 2 day history of non bilious vomiting  and diarrhoea.

Mum is unsure of the number of wet nappies due to the frequency of the stools.  Her oral intake has decreased  to around 50% of normal.  She is formula fed. Her 18 month old brother also has had diarrhoea and vomiting over the last week. O/E Child is alert, irritable but consolable.  She has sunken eyes and fontanelle, with dry mucous membranes and normal skin turgor. HR 150 Temp 36,7 RR40 Sats 98%.  Weight 4.1KG (Mum unsure of most recent weight) CPR >3seconds.

Venous gas

pH 7.14                                        Na 151mmol/l

pCO2 36mmHg                            K 5.4mmol/l

HCO3 12mmol/l                           Cl 127 mmol/l

B/E -16                                        Cr 30 umol/l

Glucose 4.1mmol/l                      Lactate 2.6 mmol/l


Describe and interpret the VBG

Discuss levels of dehydration in children. What is this child’s dehydration status?

What fluid requirements does this child need?