What can cause acetone in a child? Acetone in a child is a nightmare for parents

In this article we will analyze the causes and consequences of increased acetone in children, which in medicine is referred to as acetonemic syndrome (hereinafter AS). We will also talk about such manifestations as: “the smell of acetone from the mouth of a child”, “increased acetone in the blood of a child”, “acetone in the urine of a child”, “acetone and temperature in a child” and “cyclic vomiting”.

Why does acetone increase in children?

An increase in acetone in children makes itself felt through a complex of clinical manifestations associated with the accumulation of under-oxidized products of the “decomposition” of fats and proteins in the blood and other tissues of the child’s body. This is one of the most common diseases of childhood, in which episodes of vomiting alternate with periods of complete health of the baby.

It usually occurs in children from 2 to 10 years old, but sometimes an increase in acetone is observed in adolescence.

For the normal functioning of any organism, including a child, energy is constantly needed. Energy is most actively produced through the metabolism of carbohydrates, which involve various sugars, glucose, fructose, sucrose, bread, cereals, cereals, etc. But under various stressful situations or stress (physical, nervous, viral infections, injuries, etc.) the body needs in energy increases sharply. At the same time, energy from carbohydrates does not have time to be produced in sufficient quantities, or there are not enough carbohydrates themselves.

In this case, the body begins to oxidize fats and proteins - at the same time, energy is also produced, but in smaller quantities, and at the same time, the products of such oxidation - ketone bodies (popularly called “slags”) accumulate in the blood. Ketone bodies are toxic and actually poison the child's body. Ketone bodies irritate the mucous membrane of the baby's digestive tract and hence the abdominal pain and vomiting.

An increase in acetone in its most pronounced form is manifested by acetonemic crises (AC).

A crisis can be caused by many factors that, under conditions of high excitability of the nervous system, act as stress on the child:

• psycho-emotional stress;
• conflict (with parents, teachers, peers);
• change in the usual communication environment;
• various emotions “in abundance” (birthday with an abundance of gifts, guests and clowns, going to the circus, playgrounds, zoo);
• errors in the diet (eating tasty foods: chips, nuts, cakes, pastries, chewing gum, candies with dyes and flavors, smoked foods, fried and fatty foods in large quantities, with a lot of seasonings and spices).

Symptoms of increased acetone in children

At first glance, acetonemic crises occur suddenly. However, if you carefully analyze and remember, then each acetonemic crisis is preceded by precursors of an attack, which include:

• general malaise,
• refusal to eat,
• nausea, weakness,
• lethargy or agitation
• migraine-like headache,
• stomach ache,
• pale colored stool (gray, yellow),
• stool retention,
• There may be a peculiar “fruity, vinegary” smell from the mouth.

Parents may also notice that the baby is pale or slightly jaundiced, has a lack of desire to play, or has an apathetic facial expression.

In this period:

• the child is pale,
• with a characteristic unnatural blush on the cheeks,
• signs of intoxication are increasing,
• the acid-base balance of the blood is disturbed,
• the temperature rises to 37-38.5C,
• liver enlarges
• the child is worried about dizziness,
• headache (moderate),
• cramping or persistent pain in the abdomen, often without specific localization,
• nausea,
• then repeated, uncontrollable vomiting develops over 1-5 days with frequent, repeated attacks.

Actually, this is why in foreign literature this syndrome is called “cyclic vomiting syndrome.” As vomiting becomes more frequent, fluid loss increases and body weight loss occurs. Often the vomit contains bile, mucus, and even blood - that is, the child has nothing to vomit with. The skin is dry, pale, sometimes with a bright unnatural blush.

At this stage of the disease, parents make the most mistakes in “treating” their children. They do not understand what is happening to the child, they do not know what to feed him or whether he needs to be treated.

Most often, worried mom and dad try to force-feed the weakened baby with meat or fish broth, cottage cheese, sour cream, kefir, egg, steamed cutlet, chop and other ketogenic products.

But it is precisely this food load that aggravates metabolic disorders and contributes to the progression of the crisis. Gradually the little one's condition worsens. The child first becomes nervous, excited, runs and screams, then becomes lethargic, adynamic, apathetic, does not want anything - does not eat or drink.

Trying to feed or drink a child also provokes repeated episodes of vomiting. In most cases, a strong odor of acetone is felt in the vomit, urine and exhaled air. In severe cases, in the absence of adequate treatment, acetonemic coma may develop.

Diagnosis of acetone syndrome. Primary and secondary AC.

Before determining that your child has an increase in acetone and that this is what should be treated, the doctor needs to make sure that the acetone syndrome in your child is not a manifestation of another, more severe and dangerous disease. Such manifestations are similar to decompensated diabetes mellitus, diseases of the kidneys, thyroid gland, pancreas, toxic liver damage, traumatic brain injury, brain tumors, leukemia, hemolytic anemia, fasting, poisoning, intestinal infection, acute surgical pathology, pneumonia, etc.

In these diseases, the clinical picture is determined by the underlying disease, and acetonemic syndrome is a secondary complication of the underlying disease. This is a “secondary” speaker.

A primary increase in acetone is also distinguished. Most often, primary acetone syndrome affects children with the so-called neuro-arthritic diathesis.

Body weight is unstable, and by the age of one year, babies usually lag significantly behind their peers in weight.

The neuropsychic and intellectual development of such children, on the contrary, is ahead of age norms: children master speech early, show curiosity, interest in their surroundings, remember well and retell what they hear, but often show stubbornness and negativism, sometimes even aggression.

Children with neuro-arthritic diathesis often suffer from allergies, dermatitis, bronchial asthma, asthmatic bronchitis, urticaria, and kidney diseases. Urine tests of such children often reveal uric acid salts, oxalates, protein, and an increase in white blood cells and red blood cells.

To determine and confirm the correctness of the diagnosis, the pediatrician finds out how the child developed, what illness he had previously, what preceded the development of the disease now, what diseases were noted in the parents’ families, etc., then the child is examined and a series of tests and laboratory tests are prescribed.

Only a doctor can make a correct diagnosis! Do not try to treat your baby yourself, even if he exhibits all the symptoms described! If the pediatrician has confirmed that your child has acetone syndrome, then further measures to prevent and treat attacks can be taken independently at home (of course, if the child’s condition allows).

Treatment of acetone in children at home

At home, the most convenient and common method for determining acetone in a child’s urine. Diagnostic strips for urine analysis are a litmus strip on which test zones with reagents applied to them are attached. You need to wet a test strip in urine and after 60 seconds compare how much it has changed color with the test scale (from + to + + + +). If the result is + or + + - this is mild or moderate AS, you can carry out treatment at home, if you get +++ or + + + + - do not treat at home, take the child to the hospital.

Severe, pronounced acetonemic syndrome requires intravenous administration of drugs to replenish the volume of circulating blood and relieve swelling of the pancreas, reducing the toxic load on the kidneys and liver.

Along with diagnosis, of course, we must also carry out therapeutic measures. The diagnostic criterion for the effectiveness of your treatment at home is the child’s condition - if the child becomes more active, vomiting has decreased, he has started drinking actively, he has started eating - hurray! Everything worked out for you and you are on the right track. Positive dynamics, which means you can stay at home; If the child remains lethargic, sleeps all the time, vomiting does not go away, and it is not possible to give him something to drink or feed - do not self-medicate, go to the hospital immediately!

In the treatment of increased acetone in children, several stages can be distinguished:

• treatment at the stage of precursors of an attack;
• treatment of an attack or crisis;
• treatment during the recovery period after an attack;
• treatment during the interictal period;
• prevention of attacks.

At the 1st stage of precursors and initial symptoms, treatment is aimed at removing ketones from the body and relieving acidosis (treatment of “acidification” of the blood).

First of all, this is very important, it is necessary to cleanse the intestines with an enema with a 1% solution of baking soda (2 times a day). Drink frequently and in small portions every 10-15 minutes with a teaspoon (for children aged 6 to 10 years - with a tablespoon), drink in small portions (1-2 sips) - so as not to provoke vomiting.

Solutions for oral rehydration can be sweet black tea with or without lemon (not hot), rehydron, gastrolit, non-carbonated medium-mineralized alkaline water (Polyana Kvasova, Borjomi, dried fruit compote). During an attack, you need to use sweetened drinks (sugar, honey, glucose, fructose) in order to make up for the deficiency of simple carbohydrates.

The child should not starve, but they are selected according to the principle of aketogenicity (without the inclusion of fat, purine bases and irritating components). Eating, as well as drinking, should be frequent and divided - 5-6 times a day. At the same time, you should not force feed the child - agree that the child chooses the dishes himself, but within the framework of the diet.

The diet should be dominated by liquid oatmeal, corn, buckwheat, oatmeal, semolina porridge cooked in water, vegetable (cereal) soup, mashed potatoes in water, baked apples, biscuits. But if on the first day the baby doesn’t want to eat, don’t force him, the main thing is to let him drink.

The duration of such food restrictions is at least 5 days. To remove ketone toxins from the body, the child is given a sorbent solution to drink (early in the morning, 2 hours before meals, and in the evening - 2-3 hours after meals or in small portions throughout the day). Medicines are prescribed to reduce pain and cramps in the abdomen; for agitation, sedative herbal medicine: valerian tincture, chamomile decoction, passionflower herb extract, Pavlov’s mixture. It is not advisable for the baby to cry or be nervous, this will only increase vomiting and worsen his condition.

If at the 1st stage it was not possible to stop the AK for a number of reasons (non-compliance with doctor’s prescriptions, late treatment, etc.), an attack or crisis develops (2nd stage), which is most often accompanied by repeated or uncontrollable vomiting. The duration of vomiting ranges from several hours to 1-5 days.

Treatment is aimed at stopping vomiting, ketoacidosis - “acidification” of the blood, replenishing glucose losses, and correcting water and electrolyte metabolism. The basic principles of treatment remain the same as in the 1st stage, but with increasing fluid loss, intravenous drip administration of solutions and medications is necessary. For persistent, uncontrollable vomiting, injections of antiemetic drugs are indicated in a dosage appropriate to age.

If the child drinks willingly, intravenous administration of solutions can be completely or partially replaced by drinking alkaline mineral water and sweetened tea, compote, etc. At this stage, the treatment plan should be determined by a pediatrician; observation by a doctor and a nurse is also necessary, that is, the child should be taken to the hospital.

During the recovery period, there is an increase in the child’s activity, restoration of appetite, normalization of skin color, and positive emotions return. During this period, it is recommended to gradually restore the water-salt balance naturally and carefully expand the diet.

It is necessary to give a sufficient amount of liquid, the diet should be expanded very gradually, the child should eat in small portions, at least 5-6 times a day.

Allowed:

• croutons (preferably homemade, without spices and salt, without cheese or bacon flavors),
• biscuits,
• baked apple,
• then mashed potatoes (with water, then you can add a little butter),
• porridge,
• low-fat vegetable soups,
• lean beef (not veal, which contains many purines, like poultry),
• boiled potatoes,
• porridge (except millet and pearl barley),
• milk,
• kefir,
• homemade yogurt made from low-fat milk - no additives,
• weak tea,
• non-acidic fruits and berries, as well as decoctions from them.

According to the recommendations of doctors, it is necessary to change the eating behavior of the entire family and buy only high-quality food products. For this purpose, food for pregnant and lactating women and high-quality baby food for children are perfect. Eat with your whole family:

Note. Returns of food and cosmetic products are only possible if the packaging is undamaged.

Among the medications at this stage, sorbents (5-7 days) and metabolic stimulants (B vitamins) are prescribed for 3-4 weeks. If a child’s appetite remains low for a long time and this affects the quality of life, it is advisable to prescribe an enzyme preparation with low lipase activity and an appetite stimulant.

Prevention of increased acetone in children

Prevention of exacerbations of acetone syndrome is, perhaps, an underestimated part of treatment by many parents. After all, our well-being depends 15% on genetics, 15% on medicine and 70% on lifestyle, habits, nutrition and physical activity.

Treatment of acetonemic syndrome during the interictal period is aimed at adherence to diet, regimen and prevention of relapses of acetonemic crises.

For children with high acetone levels, adherence to the regimen is very important. The baby should live on his own schedule, convenient and familiar to him. It is necessary to avoid physical and psycho-emotional overload, prolonged sunbathing and overheating in stuffy rooms. It is advisable to limit the time you watch TV and work with your computer and phone. Especially before bed, to make it easier for the little one to fall asleep, it is better for him to read a book with you or listen to an audio fairy tale. Caress the baby and all the worries of the past day will go away. In the evening, you can take a soothing bath by adding salt with valerian or lavender to the water.

Constant, dosed physical activity is of great importance. It is very important that the child enjoys the exercise without overwork, sufficient time in the fresh air, water procedures (swimming, contrast showers, douches), sufficient long sleep (at least 8 hours), regular, varied, balanced nutrition. These simple rules will harmonize the nervous system, will have a significant positive impact on the process of optimizing metabolism and will help avoid recurrent attacks.

If there are indications, it is advisable to annually carry out sanatorium-resort treatment under drinking conditions using low-mineralized alkaline mineral waters.

A significant role in the prevention of exacerbations of acetone syndrome is played by the rehabilitation of chronic foci of infection, improvement of the functional state of the liver, urinary system and cellular metabolism, stabilization of the processes of excitation and inhibition of the child’s nervous system. Your pediatrician will tell you what medications and measures to take for this.

Children with elevated acetone are recommended to undergo a standard glucose tolerance test, ultrasound of the kidneys, liver and bile duct system once a year. Periodically (every 6 months) it is necessary to evaluate the level of uric acid in the blood and urine by determining the transport of salts, conduct a general urine test with pH determination and carry out its correction. If you see that your child is lethargic or sick, you should immediately measure the level of ketone bodies in the urine. And in a children's group, be it a kindergarten or a school, a widespread influenza infection has begun, it is necessary to adopt enhanced prevention methods.

It is better to explain in kindergarten and school that your child should not be force-fed or forced to finish fatty meat with gravy. For children with acetonemic syndrome, it is better to undereat than to overeat, food must be taken 3-5 times a day, the main meals should be in the first half of the day and do not forget to give your baby water.

And the main thing in all your, dear mothers and fathers, therapeutic and preventive measures is that the child must learn not only to follow a diet, daily routine, work and rest, and exercise regularly, but also to understand and appreciate his health.

And most importantly, all this should become his way of life!

Acetone in children up to what age

When children suffering from acetone syndrome reach the age of 10 - 12 years, the manifestations of increased acetone stop bothering them - in fact, they “disappear” for almost everyone. But this does not mean that parents can relax. No, this syndrome can later develop into other chronic diseases in adulthood.

There remains a high probability of developing diseases such as gout, obesity, impaired glucose tolerance, type 2 diabetes mellitus, urolithiasis and cholelithiasis, and early-onset arterial hypertension. In this regard, children with elevated acetone are regarded as a risk group and should be monitored by a pediatrician, endocrinologist, neuropsychiatrist, and nephrologist.

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We express special gratitude to Oksana Vlasova, Candidate of Sciences, gastroenterologist of the highest category, for preparing this material.

Acetone in the urine of a child (ketonuria or acetonuria) is a fairly common condition. It can develop both against the background of temporary disturbances in metabolic processes in healthy children, and as a result of chronic diseases of varying severity (for example, diabetes mellitus).

Moreover, regardless of the etiology of the factors causing ketonuria, this condition is very dangerous for the child’s body. Without timely and adequate medical care, pathological manifestations can quickly worsen, leading to coma and even death.

The mechanism of acetonuria in children

Increased acetone in the urine of a child occurs as a result of acetonemia (ketoacidosis) - the accumulation of ketone bodies (acetone, acetoacetic and beta-hydroxybutyric acids) in the blood. As the concentration of ketones in the blood increases, the kidneys begin to intensively remove them from the body in order to reduce the toxic effects. Therefore, an increased content of ketone bodies is noted in the urine, which classifies acetonuria as a laboratory term rather than a clinical one.

From the latter's point of view, acetonuria is a consequence of acetonemia. In children, such disorders are very often due to the fact that some organs have not yet developed enough to perform their basic functions. To understand the full picture of the development of ketonuria, it is important to know where and how acetone enters the blood and why increasing its concentration is dangerous for children. Normally, a child should not have acetone in his urine.

Ketones appear as an intermediate product when metabolic processes are disrupted - when glucose is synthesized at the expense of proteins and lipids (fats). Glucose (sugar) is the main source of energy resources for the human body. It is synthesized from easily digestible carbohydrates contained in food. Without sufficient energy reserves, cells cannot function normally (especially nerve and muscle tissue).

This means that if for some reason the glucose level in the blood decreases, the body is forced to obtain it from its own reserves, breaking down lipids and protein. This process is pathological and is called gluconeogenesis. If the body has sufficient ability to utilize toxic ketone bodies formed as a result of the breakdown of proteins and lipids, they do not have time to accumulate in the blood.

Acetone is oxidized in tissues to harmless compounds, and then removed from the human body with urine and exhaled air. In cases where ketone bodies are formed faster than the body utilizes and eliminates them, their toxic effect poses a danger to all cellular structures. First of all, the nervous system (in particular brain tissue) and the digestive system suffer - due to intoxication, the mucous membranes of the gastrointestinal tract (gastric tract) are irritated, which leads to vomiting.

As a result of such disorders, children lose a lot of fluid - with urine, vomit, and also through exhaled air. This causes further metabolic disorders and a change in the blood environment to acidic, in other words, metabolic acidosis occurs. Lack of adequate medical care leads to coma, and the child may die from cardiovascular failure or dehydration.

Causes

It is important for parents to know why ketonuria can develop in children, as well as the main signs of this condition. This will help them recognize the initial manifestations of pathology in time and take appropriate measures to eliminate it. So, the main reasons for the increase in ketones in the blood, and therefore in the urine, in children are as follows.

Decreased blood glucose concentration:

• lack of easily digestible carbohydrates in the diet - with long intervals between meals, an unbalanced or strict diet;
• decreased function of carbohydrate processing associated with enzyme deficiency or their ability;
• increased sugar consumption in the body - injuries, surgeries, stress, relapse of a chronic disease, infections, mental and physical stress.

Excessive intake of proteins and fats from food or due to gastrointestinal dysfunction, leading to disruption of their processing processes. This requires the body to create conditions for intensive utilization of proteins and lipids, resorting to gluconeogenesis. Diabetes mellitus stands out as a separate cause, leading to a high content of acetone bodies, which is called diabetic ketoacidosis.

This pathology develops as a result of a lack of insulin, when normal or increased levels of glucose cannot be absorbed due to pancreatic dysfunction. It should be noted that when the temperature is observed in a child for a long time, an increase in the level of acetone in the blood and urine can often be observed. Below is a table of normal blood glucose values ​​for children of different ages.

Acetonemia in childhood often manifests itself as a complex of certain symptoms, which is called an acetonemic crisis (AC). If such conditions are repeated two or more times, then acetone syndrome (AS) is diagnosed. Depending on the factors leading to an increase in acetone in the blood, primary and secondary AS are distinguished.

The latter develops as a result of diseases such as:

• pathologies of an infectious nature, which are characterized by high fever and vomiting (flu, sore throat, ARVI, intestinal infection);
• somatic (diseases of the gastrointestinal tract, liver, kidneys, thyrotoxicosis, anemia, diabetes, etc.);
• severe damage due to trauma, surgery.

While primary AS is mostly observed in children suffering from neuro-arthritic diathesis (NAD), which is also called uric acid. NAD is not considered a disease - it is a kind of anomaly in the development of the constitution, accompanied by a predisposition to the occurrence of pathological reactions to environmental influences.

With this deviation, excessive excitability, a shift in protein-lipid metabolism, and enzyme deficiency are observed. As a rule, children with uric acid diathesis are characterized by severe thinness, mobility and high excitability. At the same time, they are often ahead of their peers in intellectual development.

Their emotional state is quite unstable and is often combined with enuresis (uncontrolled urination) and stuttering. Pathological changes in metabolic processes in children suffering from NAD lead to excruciating pain in the joints and bones, as well as in the abdominal area. Some external influences can provoke AK in a child with uric acid diathesis:

• unbalanced or inappropriate diet;
• nervous stress, fear, pain;
• excessive positive emotions;
• long exposure to the sun;
• physical exercise.

Attention! The list of factors that can cause an acetonemic crisis in a child with NAD indicates that parents need to carefully plan their daily routine to avoid such complications.

Why are children most susceptible to developing pathology?

Nondiabetic ketoacidosis is a pathology that is mainly observed in children from 1 year to 11-13 years. After all, all people, regardless of age, are exposed to infections and other diseases, and also receive various injuries. But at the same time, in adults, ketonemia and its consequence ketonuria arise, as a rule, only as a complication of diabetes mellitus in the stage of decompensation.

Classification of causes of acetonuria

As a result of the research, it turned out that this phenomenon is due to the physiological characteristics of the child’s body, which become a provoking factor in the development of ketoacidosis.

• Firstly, the child grows actively and moves a lot, which requires much more energy than an adult.
• Children do not form sufficient reserves of glucose in the form of glycogen, while in adults its quantity allows the body to calmly wait out unfavorable moments.
• In childhood, there is a physiological deficiency of enzymes that ensure the process of utilization of ketone bodies.

In most cases, episodes of acetone syndrome cease to bother the child at the onset of puberty, around the age of 12 years.

Symptoms of acetonuria

Symptoms of this condition can increase very quickly, and in some cases even rapidly. Most often this happens:

• frequent uncontrollable vomiting, especially as a reaction to ingestion of liquid or any food;
• spasmodic pain in the abdominal area;
• increased body temperature;
• increase in liver size.

There are also signs of dehydration and intoxication - dry and pale skin, a decrease in the volume of urine produced, weakness, a coated tongue and blush on the cheeks. Then symptoms of dysfunction of the central nervous system may appear - in the initial stages of ketonemia there is excitement, quickly replaced by weakness, lethargy, and drowsiness. This condition can develop into a coma, and in some cases a convulsive syndrome develops.

But the very first symptom that parents and relatives of the child will pay attention to is, of course, the smell of acetone from the mouth, as well as from vomit and urine excreted. The smell of ketone bodies is quite peculiar - it has a sugary sweet-sour aroma, reminiscent of fruit, and more specifically, of rotten apples.

The smell can be very strong and is immediately detected upon contact with the child, but sometimes it is barely perceptible, even if the baby’s condition is quite serious and most of the signs of acetonia are visible on the face.

A urine test reveals ketonuria, blood biochemistry shows a decrease in the concentration of glucose and chlorides, an increase in the level of cholesterol and lipoproteins, and acidosis. In this case, a general blood test will determine an increased erythrocyte sedimentation rate (ESR) and an increase in the number of leukocytes. When secondary AS occurs, the symptoms of the underlying disease are added to the signs of true ketonemia.

You can determine ketonuria at home using special test strips. The strip is dipped into a sterile container with urine and then the resulting shade is compared with the color scale printed on the packaging. When the level of ketones is slightly exceeded, its color becomes pink, and when the level is high, the shade turns out to be closer to purple.

Instructions for self-determination of ketone levels

How to remove ketones from urine

When signs of acetonemia appear for the first time, which also means acetonuria, you should definitely invite a doctor or visit a clinic for advice. Depending on the severity of the patient’s condition, outpatient treatment or hospitalization will be prescribed. If the baby’s well-being allows for therapy at home, the doctor will explain in detail what parents should do to help his body get rid of toxins.

In situations where such a diagnosis is established in children, relatives often quickly cope with its manifestations at home. And only in particularly difficult situations do they resort to qualified medical care, which involves conducting a full examination of the body and prescribing complex therapy. Therapeutic measures are being developed in two directions - speedy removal of acetone and replenishment of glucose levels.

To replenish the lack of glucose, children are given sweet drinks. This can be tea, dried fruit compote, 5% glucose solution, as well as Regidron water-salt solution. To minimize gagging, the child is given water from a teaspoon every few minutes. To remove acetone, children are given a cleansing enema (sometimes even several at certain intervals), and toxin-removing drugs - enterosorbents - are also prescribed. These include the following: “Enterosgel”, “Polysorb”, “Smecta”.

Drinking more will cause your urine volume to increase, which will also help reduce ketone concentrations. Therefore, the optimal effect is observed when alternating sweet drinks with ordinary boiled or alkaline mineral water, as well as rice water. The well-known pediatrician and presenter Komarovsky claims that there is no need to force the baby to eat, but care should be taken that he is not hungry.

If the child does not refuse food, then it is better to give him easily digestible carbohydrate foods - liquid oatmeal or semolina porridge, mashed potatoes, vegetable soup, baked apple. In severe cases, the patient is hospitalized and given infusion therapy, which involves the administration of medical solutions by intravenous drip.

Prevention

After ridding the baby of signs of AK, it is necessary to create conditions so that this condition does not recur. If ketonuria was discovered for the first time, the pediatrician will recommend a comprehensive diagnosis of blood and urine and will definitely prescribe an ultrasound of the pancreas and liver. If such crises are a frequent occurrence, then you should correct the baby’s lifestyle and reconsider the main components of his diet.

For a child prone to ketonuria, adequate sleep and rest, as well as regular exposure to fresh air, are of great importance. Children with NAD should limit watching TV and not be allowed to play on the computer. Excessive mental stress and active sports training are undesirable. The best option for such children would be regular visits to the pool.

Do not forget about a constant diet that completely limits the intake of foods that increase the concentration of ketone bodies. These are fatty meats, strong broths, smoked meats, marinated dishes, etc. The diet should contain easily digestible carbohydrates in moderate quantities - sugar, honey, fruit, jam. In case of secondary acetonemia syndrome (when, for example, crises develop with every acute respiratory viral infection), it is necessary to treat not only the disease, but also carefully observe an extended drinking regimen with the introduction of the required amount of sugar.

Many mothers encounter so-called “acetone” in their babies. Strange smell from the child's mouth - the smell of acetone and sudden severe vomiting.

Of course, the first thing many parents do in such a situation is call a doctor. And rightly so! After all, the smell of acetone from the mouth, as well as the specific smell of urine, sudden vomiting may indicate that the child’s blood has increased, because of this it is released in the urine and has a toxic effect on the body. This condition is quite dangerous for the baby; it certainly requires special treatment.

Let's figure out together today why the level of acetone increases, what are the symptoms of this condition and how to stabilize the level of acetone in the blood in children?

Where does acetone come from in urine?

If a child's fat metabolism and the process of assimilation of carbohydrates in the body are disrupted, this can lead to the accumulation of a large amount of ketone bodies - acetone and acetoacetic acid - in the baby's blood. This condition is called acetonemia or, simply put, increasing acetone levels .

Ketone bodies - these are chemical compounds that are formed in the liver from food entering the body. These bodies are formed thanks to fats and proteins. In small quantities, ketone bodies are very necessary for the child’s body to function normally; they are a source of energy. But if there are too many of them, the body becomes intoxicated.

Vomiting, the smell of acetone from the child’s mouth, the release of acetone in the urine and the smell of acetone from urine are manifestations of this intoxication or the so-called acetonemic syndrome .

Causes of acetonemia in children

Among the main causes of acetonemia in children are:

• physical overload of children with insufficient body weight, very active and restless children;
• genetic tendency to metabolic disorders - if the baby has among his immediate relatives patients with gout, diabetes, urolithiasis, cholelithiasis;
• imperfection of the metabolic system of the child's body.

Maya Bodrova, pediatrician at the Dobrobut clinic: “Children’s exchange system is imperfect. Therefore, if overload occurs, for example, due to a stress factor, then the level of acetone in the blood increases, a sweetish smell from the mouth appears, and the smell of acetone from the urine appears.”

A predisposing factor to an increase in the level of acetone in the blood can be severe stress, viral infections, overwork, overexcitement, strong emotions, and an abundance of fatty foods in the diet.

Symptoms of acetonemia and acetonemic syndrome

Acetonemic syndrome is a set of symptoms associated with an increase in the level of acetone in the blood. This syndrome is characterized by vomiting, general weakness, bad breath, and a specific odor of urine and vomit.

Acetonemic syndrome is typical for children in the first year of life (from 10 months) and up to 4-7 years. Sometimes manifestations stop only after 12 years, that is, with the onset of puberty. If attacks occur later, you should contact a gastroenterologist and endocrinologist to conduct a full examination. Frequent attacks of acetonemia are dangerous.

How to determine the presence of acetone and monitor the child’s condition?

If a child experiences symptoms characteristic of acetone syndrome, it is worth checking for the presence of acetone in the urine. This can be done even at home using special test strips. They are sold in pharmacies without a prescription. Each strip has an indicator that is sensitive to acetone.

The strip should be dipped into the urine for a few seconds, removed and after a few minutes check the result. The color of the strip must be compared with the color scale on the test packaging, based on this, you can get a result based on the acetone content: positive or negative.

If a child experiences symptoms characteristic of acetone syndrome, it is worth checking for the presence of acetone in the urine. For this purpose, there are special indicator tests that are sold in any pharmacy.

If the test result shows the presence of acetone +/- (0.5 mmol/l) or + (1.5 mmol/l) - this indicates that the child’s condition can be characterized as mild. You can treat a baby in this situation at home.

If the result looks like this: ++ (4 mmol/l). This indicates that the child’s condition is moderately severe. If parents have the appropriate knowledge and experience, treatment can be done at home. But if this condition occurs for the first time, and the child’s well-being is rapidly deteriorating, you should consult a doctor.

If the result is +++ (10 mmol/l), we can talk about the child’s serious condition, which requires urgent hospitalization.

What should parents do if their child has acetonemia?

1. Be attentive to your child’s complaints . If the baby complains of feeling unwell, abdominal pain, and is lethargic, these may be symptoms of acetone syndrome and rapid vomiting. To prevent an attack, it is recommended to drink more in small portions every 10-15 minutes. In this situation, alkaline mineral waters without carbon and tea with lemon are good options. You can also give your child sorbents and do a cleansing enema.

2. If severe vomiting begins:

• the child is shown hunger;
• You should try to give the baby something to drink to remove acetone from the body;
• it is necessary to monitor the level of acetone using test strips;
• if the child’s condition worsens, you need to call a doctor, you should prepare for the fact that the child may be admitted to the hospital;
• if the treatment is correct, the child’s condition will improve, and all symptoms will disappear 2-5 days after the onset of the disease.

3. Further actions after the onset of the syndrome

If on the first day of illness the child's condition improved slightly in the evening, and you continue to be treated at home, then it is important to remember what to do next. The most important - follow a proper diet , this will help the baby recover faster. On the second day of illness, you can offer the child a drink, crackers, rice water, a baked apple; on the third day - a drink, crackers, thin rice porridge, a baked apple; on the fourth day - a drink, biscuits, rice porridge and vegetable soup with vegetable oil. Then you can expand the menu, but for a week after all the symptoms have disappeared, it is better to stick to a diet; the following will be useful: mashed potatoes with water, kefir, buckwheat porridge, oatmeal, fish, steamed meat dishes.

10 376

Acetone in the urine of a child is manifested by the presence of an unpleasant characteristic odor from the mouth, as well as an increased concentration in the body as a result of laboratory testing. Why does this happen and how to avoid it?

What is acetonemia

Acetonemia is a condition in which an increased concentration of ketone bodies accumulates in a child’s blood. As a result of insulin deficiency, ketones are synthesized. Glucose in the blood is not used for energy production, fatty tissue is destroyed, resulting in the formation of acetone in the child’s urine.

If there are small traces of ketones in the blood within normal limits, they are eliminated from the body naturally. An increased concentration indicates the development of disorders and indicates the need for treatment.

The presence of ketones in the urine is called acetonuria and is a consequence of acetonemia. Analysis of the reasons for the increased concentration of ketones in the child’s urine allows us to identify this deviation - the kidneys are the first organ to respond to changes in the balance of substances in the body, and help to identify the increased content of ketones in the urine. The content of acetone in urine within normal limits is determined by the indicator 0.01-0.03 g per day.

When diagnosing acetonemia and acetonuria, doctors often use different terminology: ketones, ketone bodies, ketonuria. Any of these concepts indicates an increased content of ketones in the child’s body. Once a high concentration in the body is reached, therapeutic measures are required to avoid serious disorders.

The danger of increased acetone content in a child’s body

The appearance of acetone in the urine is often observed in children aged 1-13 years, as well as in women during pregnancy. Before reaching the age of one, a child’s body contains special enzymes involved in the processing of ketones and the synthesis of energy from them. In the absence of clinical symptoms, increased concentrations indicate a physiological tendency to increase ketone levels.

As children grow older, the amount of these enzymes decreases significantly, which causes symptoms of increased levels of acetone in the urine. The first signs of the presence of acetone in the blood appear at the age of 4 to 5 years, and upon reaching 12 years of age, the likelihood of developing physiological acetonemia is excluded.

Acetone in children in high concentrations requires mandatory attention and medical supervision. If the level of ketone bodies is elevated, you should contact your pediatrician, who will find out the reasons for the increase in the concentration of the substance and prescribe therapeutic measures. This will help to promptly exclude the development of serious pathologies, including diabetes or malignant tumors.

The smell of acetone in a child cannot be ignored - this can provoke the development of an acetone crisis. Its main symptoms are acetonemic vomiting, increased body temperature, and loose stools. In such cases, you need to urgently call an ambulance team. If you do not help your baby in time, this can cause severe dehydration, disruption of the central nervous system, pathologies that form in the liver and kidneys, joint diseases, hypertension, and coma.

Symptoms and signs of acetone in the blood of a child

Acetone in a child's urine is associated with the manifestation of certain symptoms. Symptoms of acetone syndrome are:

• the presence of nausea and vomiting, leading to dehydration;
• significant decrease or complete absence of appetite;
• abdominal pain or cramps;
• development of general weakness;
• presence of plaque on the tongue;
• significant dry skin;
• excretion of urine in very small volumes;
• increased body temperature;
• the child’s mouth smells characteristically of acetone;
• increased excitability or lethargy;
• states of fainting, confusion;
• frequent drowsiness leading to coma.

Acetonemic syndrome can be diagnosed if the child has had several acetonemic crises during the year. The development of this pathology is associated with the presence of:

• neuro-arthritic diathesis;
• infectious pathologies;
• injuries;
• somatic diseases.

Causes and factors of increased acetone in urine in children

What leads to an increase in the level of frequent acetone in the urine of a child? The main reason for this is the formation of an excessive amount of ketones, which take part in the production of the required amount of carbohydrates by the body. Normally, ketones should be practically absent - they break down into simple sugars, but for one reason or another this process is not completed.

Ketone bodies are toxic to the body - they penetrate organs and tissues and provoke the destruction of systems and poisoning of the body. As a result, metabolic and redox processes are disrupted.

In other words, an increased level of acetone in a child’s urine demonstrates the presence of problems with the processing of carbohydrates and their breakdown - this contributes to the development of various pathologies. Getting into the kidneys through the bloodstream, this substance is detected in the urine.

The reasons for increased acetone may be the following:

Methods for diagnosing acetonemia

If you yourself have detected acetone from your child’s mouth, then first you can conduct a home diagnosis. Home diagnostics of the analysis of acetone in the blood of a child is carried out using special test strips, which, due to the presence of indicators, can detect the level of ketones in the urine. You can buy them at any pharmacy without a prescription. If test strips give a color result, then you can determine the concentration of acetone in the urine by comparing the color of the strip with the table presented on the test package. Some tests produce results in the “+/-” format:

• +/- – light level of concentration;
• + – home treatment with acetone is acceptable;
• ++ – moderate severity of the condition with a recommendation to visit a doctor;
• +++ – serious condition with mandatory hospitalization.

Home diagnostics can only detect the presence and level of ketones in the urine. In order to determine the causes of this phenomenon and prescribe treatment, as well as confirm the results of a home examination, you should consult a doctor, conduct an examination and laboratory tests of urine and blood.

Treatment and goals of therapy for elevated acetone

Therapy can begin only after a diagnosis has been made by a doctor. Treatment at home and on your own is under no circumstances allowed.

Acetonemia rarely requires hospitalization, so all therapeutic measures can be carried out at home under the supervision of physicians.

Therapy is characterized by the following goals:

• reduce the concentration of acetone;
• eliminate symptoms;
• adjust the child’s food intake;
• eliminate the causes of development.

If the elevated level of acetone in the urine is infectious, antibiotics are prescribed. To relieve intoxication and remove excess acetone from the body, sorbents are prescribed, for example, Enterosgel, activated carbon, Polysorb, Sorbex, Atoxyl, Smecta. Cerucal helps with vomiting, Betargin normalizes liver function, Creon helps the gastrointestinal tract, Regidron restores water-salt balance.

With an increased level of acetone, carbohydrate starvation of the body is observed. For treatment, droppers with glucose are prescribed, which restore the balance of substances in the body and increase blood sugar levels. Measures to prevent dehydration are also prescribed.

Treatment of acetonemia is prescribed individually depending on the symptoms and nature of the disease.

Scheme of action for emergency assistance to a child in the event of an acetonemic crisis:

• enema;
• taking sorbents to remove toxins;
• drink plenty of fluids to prevent dehydration;
• consumption of glucose in its pure form, sweet compote, tea.

Concentration can also be adjusted by proper diet. Fasting or overeating is excluded. A carbohydrate-containing diet in the presence of acetone is recommended:

• dairy products;
• vegetables;
• fruits;
• jam;
• dried fruits;
• cookie;
• sweet (dosed).

You need a diet with acetone, in which the consumption of proteins and fats is reduced, that is, the following foods are excluded:

• meat broths;
• smoked products;
• spicy food;
• fast food;
• chocolate.

During an acetone crisis, the diet involves split meals and the exclusion of fruits, fatty meats and spicy foods, smoked meats, and dairy products from the diet.

An important place in therapy is occupied by maintaining a correct lifestyle, including the presence of moderate, but not great, physical activity and adherence to sleep and wakefulness.

Komarovsky about acetone in children

According to Dr. Komarovsky, acetonemia is not a pathology. A well-known pediatrician says that increased acetone from a child’s mouth is an individual criterion of metabolism for each child. He recommends that all parents familiarize themselves with the specifics of the process of acetone formation in the child’s body in order to know how to prevent or control it.

Komarovsky talks about the controversial nature of the reasons for the development of acetone syndromes. He names starvation, the development of diabetes, pathologies of the gastrointestinal tract, infectious diseases, as well as concussions and head injuries as the main factors.

At the same time, Komarovsky emphasizes that heredity alone cannot provoke increased acetone from a child’s mouth. It also depends on the ability of the child’s body to remove toxins, break down substances, and synthesize them.

Komarovsky advises parents not to panic when they detect the smell of acetone from the child’s mouth, but to always be prepared to eliminate possible consequences.

Prevention of acetone in children

To prevent the development of the disease and crisis, parents must monitor the child’s condition and observe the following preventive measures:

• a complete diet;
• taking vitamin complexes;
• spending time outdoors;
• moderate physical activity;
• adherence to sleep and wakefulness;
• regular scheduled examinations with a pediatrician;
• do not self-medicate;
• strictly follow the instructions of doctors for diabetes;
• maintain a drinking regime to maintain water balance in the body.

Your child is vomiting, has elevated levels of acetone in the urine, and you don’t know what to do? In this review I will try to clearly describe your actions.

I seem to be an experienced mother, my children are 6 years old, and I have encountered acetone more than once. But every time I’m stressed, I frantically try to remember what to do and how. That’s why I’m writing this topic not only for other parents, but for myself too.

If a child has acetone, what is the correct way to get out of this condition?
How to stop vomiting in a child?
What is acetone, where does it come from and what drugs are there to reduce it?
I will try to answer these and other questions in detail in this topic.

Today, acetone is far from uncommon; many parents have encountered this problem. But not everyone knows why this happens. I think it is important to know this, because having basic knowledge about the cause of acetone, it will be easier to deal with the problem itself and correct your actions.

Why does acetone appear?

The source of energy in the human body is glucose. When its supply runs out (as a result of illness, temperature, stress, etc.), the body begins to break down glycogen to obtain energy, which is accumulated in reserve by the body and is contained in muscle mass and the liver. In an adult, glycogen reserves in the absence of replenishment of glucose reserves can last approximately 1-2 lives, depending on the intensity of its use. In children, glycogen reserves are an order of magnitude smaller due to physiological characteristics and are enough for only 2-3 hours. After glycogen reserves are used up, fats become a source of energy. An intermediate product of the conversion of fat into energy are ketones - acetoacetate, hydroxybuterate and acetone. For ease of understanding, these three substances are called in one word - acetone.
This is how, according to the scheme described above, acetone appears in the blood, and accordingly in the urine, since it is excreted from the body to a greater extent through the kidneys.

Whether a child develops an acetonemic state or not is determined by individual metabolic characteristics: glycogen reserves, the intensity of fat breakdown, and the ability of the kidneys to excrete acetone. Therefore, there are children in whom acetone never accumulates, even at a very high temperature and in a very serious condition, and there are those in whom an acetonemic state occurs in almost any illness. It should be noted that thin children more often suffer from acetone syndrome.

At the same time, you need to understand that the appearance of acetone is not a violation, it is a normal physiological reaction of the body. Acetone can appear due to fever, poisoning, viral diseases, improper functioning of the pancreas, stress, physical activity, etc. Increased acetone in children is not a disease in itself, but this syndrome may indicate an existing disease or problem.
But, despite this, acetone in children (acetonemic condition, syndrome) requires taking appropriate preventive measures.

How to determine if a child has acetone

With acetone syndrome, changes in the child’s behavior are first noticeable. The child becomes lethargic, nervousness and irritability often appear. A sign of increased acetone in a child is the smell of acetone from the mouth, and sometimes the smell of the skin (under the hair, behind the ear), but it also happens that there is no smell. For many, the amount of urine excreted decreases. The appearance of acetone is followed by vomiting and it is important to prevent this moment.

To monitor acetone in the body, there are special tests to determine its concentration in the urine.

The test is carried out using strips containing a special reagent. Upon contact with urine, which contains acetone, the active part of the strip changes its color depending on the concentration of acetone.

On the test packaging there is a scale with which the resulting test should be compared and the concentration of acetone should be determined by color.

In medical practice, it is customary to measure the acetone content in pluses. On the concentration scale, this corresponds to the following values ​​(mmol/l is millimoles of acetone in 1 liter of urine):
+ 1.5 mmol/l
++ 3 mmol/l
+++ 7.5 mmol/l
++++ 15 mmol/l

The test is very simple and quick.
The indicator strip should be dipped in urine, placed horizontally and waited for 3 minutes, then compared with the scale and determined which color is closest to the obtained one.

From personal experience I can say that tests that are not very late (half a year to be exact) also give the correct result.

If the test shows the presence of acetone, it is necessary to take appropriate measures to prevent a further increase in its concentration.

What to do if a child has acetone and vomits

If the levels of acetone in the urine are not high (1-2 pluses), then the child can not be limited in anything, just actively watered, given glucose (in tablets or solution) and not denied sweets. With timely, correctly carried out actions, the increase in acetone in the body will stop and there will be no acetonemic vomiting.

If acetone levels are above 3 pluses, and even more so if vomiting is involved, measures should be more drastic.

Why does vomiting occur? Acetone accumulates in the blood, irritates the mucous membranes of the gastrointestinal tract and the vomiting center in the brain. Acetonomy syndrome may also be accompanied by abdominal pain.

Vomiting can be so severe that it is not possible to give the child water. Then it is necessary to use antiemetics. At home it can be Domrid in the form of syrup.

It is a suspension that tastes quite pleasant. Before use, the bottle must be shaken well.

The dose of the drug for a child weighing less than 35 kg is 0.25 ml of suspension per 1 kg of body.
For example, if a child weighs 20 kg, then he should be given 0.25 x 20 = 5 ml of suspension. The packaging is equipped with a special measuring spoon, which has divisions of 2.5 ml and 5 ml. If you need a smaller dose, you can use a regular syringe without a needle.

The photo can be enlarged by clicking the mouse.

I can tell you from personal experience that half the age-appropriate dose was enough for us to stop vomiting.
After taking the drug you should wait 30 minutes and only then start drinking, otherwise vomiting may resume again.

The maximum daily dose of the drug should not exceed 0.75 ml per kg of body weight, i.e. in our case, with a weight of 20 kg, the drug can be drunk no more than 3 times a day, 5 ml: 0.75x20 = 15 ml

If you cannot stop vomiting on your own, you will need to seek medical help. In such cases, the child is given an intramuscular injection of an antiemetic drug, after which, while the medicine is working, they try to give him something to drink or resort to the help of a hospital, where fluid is administered intravenously (a dropper with glucose and other drugs).

Doctors often use cerucal as an antiemetic, although not all doctors approve of it (I’m writing for myself - a child needs half a standard ampoule. From the instructions: “The drug is administered intramuscularly or intravenously slowly. Adults and adolescents are usually prescribed at a dose of 10 mg (2 ml drug) 3-4 times a day. Children over 3 years of age are usually prescribed at a rate of 0.1 mg/kg body weight, if necessary, the dose is increased to 0.5 mg/kg body weight.").
An analogue of Cerucal is metoclopramide.

Attention! Do not use antiemetic drugs without a doctor's prescription.

To reduce acetone, complex therapy is used, which includes:

• glucose preparations;
• sorbents;
• electrolytes;
• hepatoprotectors (or without their use);
• other drugs based on symptoms.

In this case, they use the so-called desoldering : the child is given solutions of the above mentioned drugs in small doses (usually 1 teaspoon) at short intervals. Soldering solutions should be at room temperature.

Let's consider the listed groups of drugs in turn.

Glucose preparations

Glucose preparations prevent the buildup of acetone in the body.
For drinking, you can use pharmacy glucose (in powder, tablets, ampoules or bottles).

The pharmaceutical preparation of glucose has the following concentrations (in descending order):

• 100% powder;
• less than 100% in tablets - 1 tablet contains 1 g of glucose monohydrate; (excipients so that a tablet can be formed: potato starch, talc, calcium stearate, stearic acid);
• 40% I am in ampoules;
• 5% or 10% in bottles.

The indicated concentration of 40% means that 100 g of solution contains 40 g of glucose. One teaspoon holds approximately 2.5-3 ml of liquid. Since 1 ml of a 40% solution contains 0.4 g of glucose, then a teaspoon of glucose solution will contain 0.4x(2.5-3) = 1-1.2 g.
Thus, 1 teaspoon of a 40% solution is equivalent to 1 tablet.

From glucose powder you can prepare a solution of the desired concentration, for example 40%: dissolve 40 g of powder in 100 ml of drinking water.

Give a teaspoon of glucose approximately every 5 minutes. It is not advisable to give large volumes so as not to provoke vomiting. It should be taken into account that the absorption of liquid in acetonemic syndrome is worse than in a healthy child and the drunk liquid can accumulate in the stomach and then be poured out in full during vomiting.

If the levels of acetone in the urine are high enough, then it is better to drink with a more concentrated solution, 40%. When reducing acetone, solutions of lower concentrations can be used. Please note that the child does not like the taste of a very sweet 40% glucose solution; it is cloying and can also cause vomiting.

For drinking, you can use sweet uzvar (dried apples are best) and raisin decoction. From the experience of many parents, Coca-Cola (without gas) gives good results, but it can be recommended for older children (not for children under one year old, I would say not even up to 3 years old)

Sorbents

The appearance of acetone leads to intoxication of the body, to reduce which sorbents are used. Some sorbents work only in the stomach (activated carbon, white carbon, etc.), and some remain active until they enter the intestines (enterosorbents).
For acetonemic syndrome, both coals and enterosorbents can be used, but the latter are more effective.

The most commonly used are atoxil and enterosgel, as well as smecta. It is easier for children to drink atoxil; it is more finely dispersed and less likely to provoke the gag reflex. Atoxyl is silicon dioxide with a high specific surface area, due to which it has the ability to “cling” to its structure, similar to a washcloth, various substances.

This is how the Betargin ampoule looks original. The drug is expensive, but at the pharmacy you can buy it individually, one ampoule at a time.

To pour out the contents of the ampoule, it must be broken off at both ends.
To use, dilute the contents of the ampoule in a glass of water and drink 1 teaspoon at a time.

I will provide links to drugs of the same pharmacological group. If it is not possible to buy the drugs listed above, then you can use an existing drug from this list.
http://www.medcentre24.ru/betargin-analogi
http://www.medcentre.com.ua/betargin-analogi
http://medbrowse.com.ua/citrarginin-analogi

Other drugs

Among the drugs that are effective and often used for acetonemia, the following can be listed:

Nicotinamide is a vitamin, one of the effects of which is the regulation of glucose metabolism. It comes in tablets and ampoules. Take a dose of 5 mg per 1 kg of weight 3 times a day; 1 ml of 5% solution contains 50 mg of substance.

You can add ascorbic acid with glucose (white vitamins). In hospitals, cocarboxylase is almost always administered intramuscularly, but you can drink it at home.

To improve digestion and reduce the load on the pancreas, doctors often recommend taking enzymes: Pancreatin, Creon, Mezim, Festal, Enzisital, Somilaza, Panzinorm, Nigedaza, Oraza, etc.

They can be included in the treatment regimen immediately, or they can be added during the recovery period, when the acetone crisis has passed. Personally, I do not use them during acetone surges, so as not to increase the drug load on the body during this period.

The recovery regimen often includes probiotics and enzymes, for example, enterozermina, symbiter, etc.
There will be more detailed information about enzymes, probiotics and enzymes in another review.

This scheme includes drugs whose action is aimed at stopping the release of acetone, its sorption and excretion. Most often, this is the regimen I use to treat my children.

1. Glucose ampoule, 40%. Drink 1 teaspoon every 5-10 minutes. Then use lower concentrations of glucose. It is better to take glucose with water (a teaspoon) so as not to provoke vomiting.

2. Dilute a packet of Regidron powder in 0.5 liters of drinking water (boiled and cooled to room temperature).
Drink 1 teaspoon every 3-5 minutes

3. Dilute Atoxyl in 100-150 ml of drinking water (boiled and cooled to room temperature)
Drink 1 teaspoon every 15 minutes.

4. Drink 1 teaspoon of Uzvar every 5 minutes.
If the child does not like the taste of electrolyte or Atoxil, then you can try to drink it with uzvar. Uzvar has a diuretic effect, which is very useful in this case; acetone will be excreted faster. It is best to use homemade dried fruits without additives.

It is very important to drink in small portions so as not to provoke another vomiting in the child. Even if the child asks for a drink and is ready to drink a lot, it is better not to do this, since a new attack of vomiting can worsen the situation.

Drinking should be carried out as long as there are elevated acetone levels and vomiting, even when the child is sleeping. If you can’t drink from a teaspoon, for these purposes it is convenient to use any dosage syringe with measured divisions in ml from another medicine or a regular injection syringe (without a needle).

It should be noted that glucose works faster than an alkaline drink, so this is the first thing to do.

Additional measures should include a cleansing enema. Most often it is made with an alkaline solution. An alkaline environment (both drinking and enema) promotes the breakdown and elimination of acetone.

If vomiting continues for less than a day, then significant dehydration has not yet occurred and, following simple rules, the child can be quickly removed from this situation. In case of severe dehydration of the body with prolonged vomiting, diarrhea and large readings of acetone in the urine, more radical measures should be taken - it is better to go to the inpatient department and carry out deintoxication under the supervision of a doctor. Intravenous drip administration of drugs reduces acetone faster than orally taken drugs.

Children outgrow the tendency to acetonemia by about 7-10 years of age. But if acetone appears in a child over 7 years old, this is a reason for a serious examination. It is necessary to take a blood sugar test from a finger prick, as well as a urine test for sugar.
Glucose deficiency and, accordingly, the appearance of acetone is one of the symptoms of diabetes. But with this disease, the problem is not that there is not enough glucose, but that it is not absorbed. Hence the completely different treatment methods.

Diet and prevention measures

Which foods can be eaten and which cannot be eaten, follows from the very definition of the source of acetone. Namely, it is necessary to exclude all products that contain animal fats, including broths and dairy products (with the exception of low-fat).
You should also exclude foods that irritate the mucous membranes of the stomach and intestines, so as not to provoke or aggravate vomiting. In this case, it is good to follow diet No. 5.

There is no need to completely deny your child sweets (except for chocolate and sweets that include animal fats), in this case such products are necessary, but do not overdo it, find the optimal middle ground and look at the child’s condition. It is good to replace sugar (sucrose) with fructose.
It is wise to include baked apples in your diet; they contain pectin, which is a good sorbent and acts like, for example, atoxyl.

During times of high acetone and vomiting, a stricter diet should be followed. In the first days of a crisis, people often refuse food completely. As your condition improves, you need to maintain a diet for a certain time to allow the body to recover. Nutrition must be introduced very carefully, it should be in small portions and often. To support the pancreas, you can take enzymes.

When choosing which products are allowed and which are not, one must also take into account the presence of allergic reactions. After all, they can also cause an increase in acetone.

Full recovery from acetone syndrome occurs differently for everyone: it can take a week, maybe three, and sometimes much more. It all depends on the severity of the course, the state of the body, the specifics of metabolic processes, concomitant diseases, etc. The longer the child is kept on the correct diet after acetonemic syndrome, the less likely it is to return.

As an example, I will show one of the cases of an acetone crisis in my child.- in test indicators. The above-described scheme was used for treatment.

The acetone rose sharply in the evening or at night, the moment of onset was missed, and at night there was severe vomiting with a large amount of liquid. There was no temperature. The test strip showed acetone over 4 plus (significantly darker than the last value on the color scale).

To stop vomiting, Domrid was used (one-time use). With constant desoldering according to the above scheme, by the evening of the first day the acetone practically did not decrease. In the evening the vomiting repeated. A half dose of Domrid was given and feeding continued.

At night, acetone began to decrease (3 pluses), this happened after about a day of active desoldering.

After a couple of hours it dropped to 2 pluses. There was no more vomiting. The child fell asleep.

In the morning there was a slight increase in the concentration of acetone. This always happens, since morning urine is more concentrated if the child did not go to the toilet at night.

In our case, the increase in acetone was most likely provoked by the currently active intestinal flu virus (rotavirus).
I hope that in the current unfavorable epidemiological situation, my review will be useful to parents, so I hastened to publish it.

Finally, I would like to thank Dr. Komarovskiy for the clarifications and recommendations, they were very useful to me http://video.komarovskiy.net/aceton-06-03-2011.html

Thank you for your attention!
Good health to everyone!