acetone in the urine of the child (acetonuria) - frequent condition that may be caused as a temporary metabolic disorders in otherwise healthy children and severe chronic diseases (diabetes mellitus).Regardless of the reasons acetonuria - a dangerous condition that can progress rapidly and become a threat to the life of the child. Content
acetonuria arises as a consequence acetonemia (ketoacidosis) - the appearance of ketone bodies (acetone, beta-hydroxybutyric andacetoacetic acid) in the blood.At high concentrations of ketone bodies in the blood of the kidneys begin to actively withdraw their urine, which can be easily detected in the analysis, so aceto
first try to figure out how to do ketone bodies into the blood and how it can be dangerous.Normally, the child's blood acetone should not be.Ketone bodies are intermediate in metabolic pathological involvement of protein and fat in the synthesis of glucose.Glucose - the main source of energy for the human body.It is formed by cleavage of carbohydrate, coming to us with food.Without energy, existence is impossible, and if for some reason the blood glucose level is reduced, our body begins to break down its own fat and protein to produce glucose - these pathological processes are known as gluconeogenesis.During the breakdown of protein and fat produces toxic ketone bodies, which are first time to oxidize tissues to non-hazardous products, and excreted in the urine and exhaled air.When
ketone formation rate exceeds the rate of their removal and disposal, they begin to damage all the cells in the first cell of the brain;irritate the mucous membranes of the digestive tract - vomiting occurs.With vomit, urine and breath through a child loses a lot of fluid.At the same time progressing metabolic disorders, reaction of the blood shifts to the acid side - developing metabolic acidosis.Without adequate treatment, the child falls into a coma and may die from dehydration or cardiovascular disease.
acetonemia children manifest the characteristic symptoms of the complex - atsetonemicheskim crisis.If crises are repeated several times, that indicate the presence of a child atsetonemicheskogo syndrome.
Depending on the reasons acetonemia distinguish between primary and secondary atsetonemichesky syndrome.Secondary atsetonemichesky syndrome develops against the background of other diseases:
Primary atsetonemichesky syndrome is most often recorded in children with neuro-arthritic (uric acid) diathesis.Neuro-arthritic diathesis is not a disease, the so-called anomaly constitutional predisposition to the development of certain pathological reactions in response to external stimuli.If urate diathesis observed increased nervous irritability, enzyme deficiency, disturbances in the metabolism of proteins and fats.
children with neuro-arthritic diathesis are thin, highly mobile, high-strung, often ahead of their peers in intellectual development.They are emotionally unstable, they are often celebrated enuresis, stuttering.Because metabolic disorders, children with uric acid diathesis suffer pains in the joints and bones, occasionally complain of abdominal pain.
triggering factor for the development of atsetonemicheskogo crisis in a child with an abnormality of neuro-arthritic constitution may provide the following external influences:
non-diabetic ketoacidosis recorded mainly in children aged 1 year to 11-13 years.But adults as well as children, vulnerable to infection, injury and other diseases.However acetonemia they usually only occurs as a complication of diabetes decompensated.The fact that a number of physiological characteristics of the child's body predisposes to the development of ketoacidosis in case of provoking situations:
In secondary atsetonemicheskom syndrome symptoms actually acetonemia overlap symptoms of the underlying disease (flu, sore throats, intestinal infection, and so on. D.).
If signs of crisis appeared atsetonemicheskogo your child for the first time, be sure to call your doctor: it determines the cause of acetonemia and prescribe appropriate treatment, if necessary - in the hospital.When atsetonemicheskom syndrome when crises arise often, parents in most cases successfully cope with them at home.But when the child serious condition (uncontrollable vomiting, severe weakness, drowsiness, convulsions, loss of consciousness) or no effect of treatment during the day necessarily require hospitalization.
treatment is carried out in two main areas: acceleration of excretion of ketones and providing the body the required amount of glucose.
shortfall for the child should be given a glucose drink sweet tea with sugar, honey, 5% glucose solution, rehydron, compote of dried fruits.In order not to provoke vomiting, drink offer of a teaspoon every 3-5 minutes and otpaivat child must be at night.
For removing ketones child performed enema appointed chelators (Smecta, Polysorb, Polyphepan, Filtrum, Enterosgel).Otpaivanie and an increase in urine output will also promote the excretion of ketones, so sweet drink alternated with alkaline mineral water, the usual boiled water, rice water.
forced to eat the baby should not be, but it should and fast.If a child asks to eat, you can give it a digestible, carbohydrate-rich foods: liquid or semolina porridge, potatoes and carrot puree, vegetable soup, baked apple, biscuit.
When the child serious condition requiring hospitalization to conduct infusion therapy (intravenous drip of fluids).
After arresting atsetonemicheskogo crisis should create all possible conditions to ensure that this crisis does not happen again.If the acetone in the urine increased once, you should consult with your pediatrician about the need for examination of the child (general analysis of blood and urine tests, blood sugar, blood biochemistry, ultrasound of the liver, pancreas, and so on. D.).If atsetonemicheskie crises arise often, a child needs correction lifestyle and constant diet.
Correction lifestyle involves normalization of the daily routine, adequate nighttime sleep and daytime recreation, daily walks in the fresh air.Children with uric acid diathesis is recommended to limit TV viewing, computer games are better to eliminate completely.It is undesirable excessive mental load in the form of extra classes at school, physical activity should also be monitored.The practice of sport is possible, but not at the professional level (excludes handling and sporting events).Very well, if you have the opportunity to walk with a baby in a swimming pool.
diet should be followed consistently.From the diet eliminated the so-called ketogenic products (can raise blood ketones): fatty meats and fish offal, smoked, rich broth, mushrooms, pickles, sour cream, cream, sorrel, tomatoes, oranges, coffee and cocoa products.Never give your child fast food, sodas, chips, crackers and other foods, saturated with preservatives and dyes.The daily menu must be available carbohydrate (fruit, biscuits, honey, sugar, jam) - in reasonable quantities, of course.
If a child holds a secondary atsetonemichesky syndrome when crises accompany each episode of SARS, if any infection is the main task of parents is to prevent acetonemia through advanced drinking regime and ensure the child's source of glucose.