Medical Management of Fluid & Electrolyte Disorders in Children
NYU Langone doctors often prescribe fluid replacement for an infant or child who is dehydrated and has an electrolyte imbalance. Other treatments are based on the severity and cause of the condition.
Oral rehydration solutions are beverages, such as Pedialyte®, that contain the correct proportion of water and salts needed to replace fluids and electrolytes.
Doctors often recommend oral rehydration solutions for young children who are dehydrated due to vomiting and diarrhea. These solutions are best tolerated when given in small amounts at room temperature.
If your baby has diarrhea, an oral rehydration solution can be given in addition to breast milk or formula. Temporarily switching to a lactose-free formula, which is easier to digest, may be helpful for babies who have severe diarrhea.
Older children who have mild dehydration caused by excessive sweating or physical exertion may rehydrate with a sports drink, which contains water and electrolytes.
Doctors may recommend diuretics, which are taken by mouth, for children who have a buildup of certain electrolytes, such as calcium or potassium, due to an underlying medical condition, such as chronic kidney disease. These medications help remove electrolytes quickly by increasing the production of urine.
Be sure your child drinks adequate fluid to replace the fluids lost through excessive urination.
Treatment with a potassium-lowering medication called sodium polystyrene sulfonate may be recommended if your child has excess levels of potassium, also known as hyperkalemia. This condition can occur in children with an adrenal gland problem or poor kidney function. Sodium polystyrene sulfate can be given by mouth or through an enema.
Fluids and electrolytes can be delivered through an intravenous (IV) catheter, which is a thin, plastic tube inserted into a vein in your child’s arm or leg. This occurs in the hospital.
IV therapy is the fastest way to replenish fluids and electrolytes in an infant or child who has severe dehydration, especially if he or she has a serious underlying medical condition and is too ill to tolerate oral rehydration.
This treatment also ensures that your child receives the appropriate amount of fluid and electrolytes. Pediatric specialists at NYU Langone carefully monitor your child during IV therapy to prevent complications, such as correcting sodium levels too quickly.
In children with chronic kidney disease, hemodialysis may be temporarily needed to remove excess electrolytes from the blood.
To perform hemodialysis, the doctor inserts a catheter into one of your child’s veins, usually in the groin, neck, or upper part of the chest. The catheter allows your child’s blood to flow into an artificial kidney machine, called a dialyzer, which removes excess electrolytes and waste products from the blood. The filtered blood is then returned to the body through another catheter.
Hemodialysis is painless and can be performed continuously for a few days while your child is in the hospital, until your child’s kidneys can filter blood effectively on their own. Doctors stop hemodialysis after your child’s kidney function returns to normal.