Increased acetone in a child. Acetone in the urine of a child: causes, how to act, why it happens and what is the rate of the indicator

With an increase in the level of acetone in the blood and urine of a child, the most important thing is to prevent dehydration. This is what mom and dad should do

How to know if a child has high acetone

To be honest, it is difficult to miss this state - when the level is raised, the baby feels very bad. However, if the attack happens for the first time, you can confuse it with poisoning or an intestinal infection.

The sooner the beginning acetonemic crisis is identified and measures taken, the easier the child will endure it - in any case, it is important to support children's body in the fight against ketone bodies for 4-6 days, after which improvement will begin.

Signs of increased acetone in a child:

Take action if you smell the sweet fruity smell of baby breath, slightly reminiscent of vinegar
The child becomes less active, feels weak, wants to lie down
Some time after the smell appears, the baby begins to feel nausea and vomiting, which cannot be stopped.
Lack of appetite
Get test strips at the pharmacy, with which you can determine the level of acetone in the urine

Reasons for the appearance of acetone in a child

In short, the reason for the release of ketone bodies is the insufficient intake of the main source of energy, glucose, into the child's body, or its overexpenditure. Why is the problem with acetone so common in children, and completely healthy, and practically does not happen in adults. The fact is that carbohydrates, in particular glucose, which come with food, are used as "fuel" as needed. The excess is stored in the liver as glycogen, which is released when needed. Because the baby's liver is still too small to store enough glycogen, with an increase in energy consumption, it is still not enough. And then the breakdown of fats into glucose and acetone begins, which enters the urine and must be excreted by the kidneys. When ketone bodies (which include acetone) are in the child's blood, they enter the brain, irritating the vomiting center, and also act on the mucous membranes of the gastrointestinal tract.

In addition, adults have enzymes that cope with the breakdown and removal of acetone, and in the children's body they begin to be produced in sufficient quantities a few days after the release of ketone bodies into the blood.

Children are most often prone to acetonemia asthenic physique- skinny and active

Acetone in the blood and urine can appear with significant energy consumption of the child - active games, running, emotional stress

A baby’s illness, a sharp rise in temperature, especially if he does not drink enough liquid, can start the process of releasing ketone bodies. Improper nutrition, excess fatty and protein (meat products, eggs, etc.) food with a lack of fiber (fruits and vegetables) is also a risk factor for a child

Not all children are prone to acetonemia, however, if the trouble happened once, parents should be prepared for a relapse

In most cases, acetonemia is an extremely unpleasant phenomenon, but it is considered a variant of the norm, but it can be a sign of a disease, for example, diabetes. Therefore, after the first attack, it is worth holding full examination child to rule out this possibility.

(photo by Legion-Media)

Treatment

Treatment of high acetone at home

At the first signs of illness, the child should be put to bed, he himself will want it.
Give the child glucose to drink. The drug is sold in pharmacies in ampoules and vials for injection, it happens in tablets of different concentrations. The solution should be given to the baby at the rate of 5 mg per 1 kg of weight, for better absorption, its temperature should approach body temperature. Drink 3-4 times a day.

The child should drink a lot, preferably sweet warm. The child should drink in small sips with interruptions, so as not to provoke vomiting, every 5-10 minutes. The best absorbed liquid, the temperature of which is close to body temperature.

While the attack continues, do not feed the child, but he, most likely, will not want to eat. If he suddenly asks to eat, offer crackers from wheat bread or a little baked apple, but not earlier than 30-40 minutes after vomiting.

If you can’t get the poor fellow to drink - every sip ends with vomiting or the baby categorically refuses to drink, this is very dangerous for his health and even life. With a lack of fluid, the concentration of ketone bodies in the blood and urine rises sharply, vomiting intensifies, which is fraught with dehydration and disruption of the kidneys. In this case, you may need to see a doctor, you may have to go to the hospital, where glucose and the necessary fluid will be administered using a dropper.

With the right behavior of the parents, the child's condition should improve already on the 2-3rd day. After an attack, it is important to follow a diet, gradually, in small portions. Exclude fatty and protein foods, chocolate, eggs, and in the future try to keep a balance in the baby's nutrition

Prevention of acetone crisis

With increased loads - sports training, active games, as well as possible emotional outbursts, make sure that the child drinks a lot. In such situations, do not limit it in fast carbohydrates, but let it not be chocolate, but, for example, caramel.

Do not overload the children's body with fatty and meat foods. The diet should be more vegetables and fruits, dairy products and cereals.

If a child is prone to an increase in acetone, keep test strips and ampoules or glucose tablets at home - this will help to identify the problem in time and quickly stop it. You may even be able to avoid vomiting.

In the vast majority of cases, seizures become less frequent and weaker with age, and by the age of 8-12 they stop altogether.

Here is what Dr. Komarovsky says about this problem:

We hope that our article will help in the treatment and prevention of this disease in a child, because the health of our babies is the most important and priority task, right? What methods do you use?
READ MORE.

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

At the same time, regardless of the etiology of the factors causing ketonuria, given state very dangerous for children. Pathological manifestations Without the provision of timely and adequate medical care, they can quickly worsen, up to the onset of coma and even death.

The mechanism of occurrence of acetonuria in children

Elevated 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. With an increase in the concentration of ketones in the blood, the kidneys begin to intensively remove them from the body in order to reduce the toxic effect. Therefore, an increased content of ketone bodies is noted in the urine, which refers acetonuria more to laboratory terms, and not to clinical ones.

From the point of view of the latter, 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 bloodstream and why an increase in its concentration is dangerous for children. Normally, a child should not have acetone in the urine.

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

And this means that if, for some reason, the content of glucose in the blood decreases, then the body is forced to receive it from its own reserves, breaking down lipids and protein. This process is pathological and is called gluconeogenesis. With a sufficient ability of the body 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 excreted from human body with urine and exhaled air. In cases where ketone bodies are formed faster than the body utilizes and removes, their toxic effect is dangerous for everyone. cell 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 are irritated ( gastric tract), leading 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. Lack of adequate medical care leads to coma and the child may die from cardiovascular insufficiency or dehydration.

The reasons

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 to recognize the initial manifestations of the 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.

Decrease in blood glucose concentration:

lack of easily digestible carbohydrates in the diet - with long intervals between meals, an unbalanced or strict diet;
a decrease in the function of processing carbohydrates associated with a lack of enzymes or their ability;
increased consumption of sugar in the body - trauma, surgery, stress, relapse of a chronic disease, infections, mental and physical exercise.

Excessive intake of proteins and fats with food or due to dysfunction of the gastrointestinal tract, leading to disruption of their processing processes. This requires the body to create conditions for the intensive utilization of proteins and lipids, resorting to gluconeogenesis. Diabetes mellitus is singled 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 elevated glucose levels cannot be absorbed due to pancreatic dysfunction. It should be noted that at a temperature observed in a child for a long time, an increase in the level of acetone in the blood and urine can often be noted. Further table normal values blood glucose levels for children of all ages.

Acetonemia in childhood is often manifested by a complex certain symptoms, which is called acetone crisis (AK). If a similar states repeated two or more times, then the diagnosis of acetonemic syndrome (AS) is established. 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 the occurrence of diseases, such as:

pathology infectious nature, which are characterized heat and vomiting (flu, tonsillitis, SARS, intestinal infection);
somatic (diseases of the gastrointestinal tract, liver, kidneys, thyrotoxicosis, anemia, diabetes mellitus, etc.);
severe injuries as a result of trauma, surgical intervention.

Whereas 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 pathological reactions on the influence of the external environment.

With this deviation, there is excessive excitability, a shift in protein-lipid metabolism, as well as enzyme deficiency. 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.

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

an 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 acetone crisis in a child with NAD indicates that parents need to carefully plan their regimen and daily routine in order to avoid such complications.

Why are children most susceptible to the development of pathology?

Non-diabetic 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 occur, 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 was found that this phenomenon is due to physiological features the child's body, which become a provoking factor in the development of ketoacidosis.

Firstly, the child is actively growing and moving a lot, which requires much more energy than an adult.
In children, sufficient reserves of glucose in the form of glycogen are not formed, while in adults, its amount allows the body to calmly wait out adverse moments.
In childhood, there is a physiological lack of enzymes that provide the process of utilization of ketone bodies.

In most cases, episodes of acetonemic syndrome cease to disturb the child at the onset of puberty, at about the age of 12 years.

Symptoms of acetonuria

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

frequent uncontrollable vomiting, especially as a reaction to the intake of liquid or any food;
pain in the abdomen of a spastic nature;
increase in body temperature;
enlargement of the liver.

There are also signs of dehydration and intoxication - dryness and pallor. skin, decreased urine output, weakness, coated tongue and flushed cheeks. Then there may be symptoms of a violation of the activity of the central nervous system, - on the initial stages ketonemia, there is excitement, quickly replaced by weakness, lethargy, 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. The smell of ketone bodies is quite peculiar - it has a sugary sweet-sour aroma, reminiscent of fruity, and more specifically 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 severe and most of the signs of acetonia are on the face.

In the analysis of urine, ketonuria is noted, in the biochemistry of blood, a decrease in the concentration of glucose and chlorides, an increase in the level of cholesterol and lipoproteins, and acidosis. At the same time, in general analysis blood will be determined by an increased erythrocyte sedimentation rate (ESR) and an increase in the number of leukocytes. When secondary AS occurs, the symptoms of the underlying disease join the signs of true ketonemia.

You can determine ketonuria at home by using special test strips. The strip is lowered into a sterile container with urine and then the resulting shade is compared with the color scale printed on the package. With a slight excess of the level of ketones, its color becomes pink, and with high rate The color is closer to purple.

Instruction for self-determination ketone levels

How to remove ketones from urine

When signs of acetonemia appear for the first time, which also means acetonuria, it is imperative to invite a doctor or visit a clinic for a consultation. Depending on the severity of the patient's condition, outpatient treatment or hospitalization will be prescribed. If the baby’s well-being allows therapy at home, then 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 special difficult situations resort to qualified medical care, which involves a complete examination of the body and the appointment complex therapy. Therapeutic measures are being developed in two directions - the speedy withdrawal of acetone and the replenishment of glucose levels.

To replenish the lack of glucose, children are given a sweet drink. It can be tea, compote of their dried fruits, 5% glucose solution, as well as saline solution"Rehydron". To minimize vomiting, the child is fed from a teaspoon every few minutes. To remove acetone, children are given a cleansing enema (sometimes even several with a certain frequency), and detoxifying drugs - enterosorbents are also prescribed. These include the following: Enterosgel, Polysorb, Smekta.

Drinking plenty of fluids will lead to an increase in urine volume, which will also help reduce the concentration of ketones. Therefore, the optimal effect is observed when alternating sweet drink with ordinary boiled or alkaline mineral water, as well as rice water. The well-known pediatrician and host Komarovsky claims that it is not necessary to force the baby to eat, but at the same time, 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 food - liquid oatmeal or semolina, mashed potatoes, vegetable soup, a baked apple. With a severe status of the patient, they are hospitalized and infusion therapy is carried out, which implies the introduction medical solutions by drip intravenously.

Prevention

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

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

Do not forget about a constant diet that completely limits the intake of food that increases the concentration of ketone bodies. These are fatty meats, strong broths, smoked meats, marinated dishes, etc. The diet should contain easily digestible carbohydrates in moderation - sugar, honey, fruits, jam. With a secondary syndrome of acetonemia (when, for example, crises develop with each ARVI disease), it is necessary to treat not only the disease, but also carefully observe the extended drinking regimen with the introduction required amount Sahara.

Elevated acetone in the urine of a child (the scientific name for this phenomenon is acetonomic syndrome) is an acute reaction on the part of the body to a violation of metabolic processes. provoke pathological changes can be a strong emotional experience, stress, viral defeat organism and malnutrition(with what it can be, both malnutrition and overeating, as well as the use of new products for the body). Disease has been observed in infancy and, as a rule, passes by 12-15 years.

The manifestation of the anomaly is characterized by an increase in acetone (acetoacetic acid), abdominal pain, nausea and vomiting. At the same time, the child has an unpleasant acetone smell from the mouth. With a frequent increase in acetone, acetonomic syndrome develops.

There are two forms of the disease:

Primary - is an independent pathology, develops in infancy from one year.
Secondary - occurs against the background of other diseases, for example, with leukemia, prolonged starvation, and concussion.

Children with acetonomic syndrome are often underweight, lagging behind in physical development, but at the same time they are ahead of their peers in psychological and mental terms. So, they quickly remember any information, are able to build logical chains and are very inquisitive. Often in children there is a violation of the metabolic processes of purines and uric acid, which at an older age can lead to the development of a number of diseases - gout, diabetes mellitus and urolithiasis.

Causes of increased acetone

Many factors contribute to the increase in acetone in the urine of a child:

Deficiency of carbohydrates in the child's diet and overuse fatty food.
Lack of income nutrients in the body - starvation.
Violation of the liver and pancreas.
Severe stress or psycho-emotional experience.
Viral or infection body that disrupts metabolic processes. In particular, it is gastroenteritis, SARS, influenza.
body intoxication.

Symptoms of acetone in the urine

With increased acetone in the urine, the child is tormented by the following unpleasant symptoms:

Diagnosis of the disease

To make a diagnosis of "acetonomic syndrome", it is necessary to analyze the child's complaints and conduct a series of laboratory research. To date, identify elevated acetone the child can be at home, using special test strips for this, which can be purchased at the store. To conduct the test, it is necessary to collect the child's urine in a sterile container and lower it for a few seconds. biological fluid test strip. Compare the shade of the control area with the color scale on the package. As a rule, any change in the color of the test strip indicates elevated content acetone in urine.

In any case, consultation is indispensable. The doctor evaluates general state health and appoints a number of laboratory tests:

Treatment of acetone in a child

Treatment of elevated acetone includes three important components: diet, replenishment of water balance and elimination of intoxication of the body. To achieve positive dynamics, it is imperative to follow all the recommendations of the doctor, and if there is no improvement, you must immediately contact the hospital.

The following drugs will help eliminate intoxication: Sorbeks or Activated carbon(take 1 capsule every 3-4 hours), Regidron solution (1 teaspoon every 5-10 minutes), Enterosgel (1 teaspoon 4-5 times a day). An intravenous infusion of 5% glucose and saline may be used to improve the condition.

To restore water balance and reduce the likelihood of developing dehydration, it is important to provide the child with plenty of fluids, despite all the reluctance of the child. Drinking should be given in small portions, but often - this will avoid the urge to vomit. As a liquid, you can use a sweet compote of dried fruits, green tea, mineral water without gases (REO-water, which can be purchased at a pharmacy, has shown effectiveness in combating high acetone).

The essence of the diet with elevated acetone: limiting the consumption of food, in particular, fatty foods, fried, spicy, chocolate, eggs and carbonated drinks. It is recommended to take easily digestible carbohydrates to compensate for the deficiency of glucose in the body.

To suppress vomiting, Motilium (1 tablet three times a day) or Metoclopramide (3 times a day up to 5 mg) is used.

Subject to all recommendations, the manifestation of acetonomic syndrome disappears for 3-5 days. Except medical measures, it is important to provide the child with complete emotional peace and protection of the patient from viral and infectious diseases.

At severe pain you can stop the symptom with the help of antispasmodics - No-shpy, Drotaverine. Antipyretics - Paracetamol, Nurofen or Panadol will help bring down the temperature.

To reduce acetone in the urine, traditional medicine methods are used:

A decoction of raisins with a little sugar. This drink will replenish water balance and eliminate glucose deficiency.
Pour a tablespoon of lemon balm with 250 ml of boiling water and insist for an hour. Drink 1 tbsp. l. 4-6 times a day. You can use mint in a similar way.
According to latest research it has been proven that the use of a small amount of Coca-Cola, from which gases must first be removed, can reduce the level of acetone in the blood.

Prevention of acetone increase

Children prone to an increase in acetone are required to adhere to a diet based on fresh fruits and vegetables, cereals, dairy products and low-fat meat. It is important to eat often, but in small portions. It is necessary to limit the use of smoked meats, fried meats, offal, fatty meats, chocolate, citrus fruits and sorrel.

For those who are prone to acetonomic syndrome, it is important to avoid severe stress and emotional experiences (whether this applies to both negative and positive impressions), it is impossible to stay in the sun for a long time. It is important to provide the child with moderate physical activity and frequent walks in the fresh air.

Acetone in the urine of a child often occurs against the background of diet errors - overeating or starvation, when the necessary glucose does not enter the body. But glucose deficiency can also be explained by a lack of insulin. It is important to solve the fundamental question: what provokes acetone in the urine? Based on this, treatment is prescribed.

Acetone in urine, ketones, acetonuria, ketonuria, ketone bodies are synonymous terms that characterize one phenomenon - high level ketone bodies in urine. Such results of the analysis indicate an increased content of acetone in the blood, or acetonemia. Normally, ketones are present in a small amount in the body, but are quickly excreted through sweating, breathing, and urination. Excessive acetone in the urine can indicate serious malfunctions in the body associated with disruption of the digestive system and metabolism. What is the mechanism for the appearance of excess acetone in the blood? With a deficiency of glucose in the body, fat cells begin to break down in order to obtain the necessary energy. Acetone is the result of the breakdown of fats, which enters the bloodstream and leads to intoxication of the body. The latter is expressed by nausea and persistent vomiting. If you do not stop vomiting, dehydration begins, which enhances the process of intoxication even more.

Reasons for the increase

The causes of acetone in the urine of a child can be physiological, related to nutrition, lifestyle, occupation, and even temperament. These include:

overwork, physical and emotional stress;
hypothermia;
lack of water in the body;
hot weather;
constant stress;
long journeys;
malnutrition with large quantity fats, proteins;
prolonged fasting, lack of carbohydrates, calories;
pH violation;
binge eating.

In 90% of cases, acetone in the urine is due to the immaturity of the enzyme system in children, dietary disorders, high energy expenditure and lack of glucose reserves in the child's body. But there are more serious reasons:

diabetes mellitus and other metabolic disorders;
infectious diseases;
heat;
exacerbation of chronic diseases;
postoperative period;
trauma;
intoxication with food, chemical poisoning;
vomiting and diarrhea;
digestive disorders;
enzyme deficiency;
anemia;
congenital pathologies of the esophagus;
oncology;
psychical deviations.

How does acetonemia manifest itself?

What can be the symptoms of acetone in a child, in addition to detecting it in the urine?

Temperature rise.
Cramps in the abdomen.
Diarrhea.
Often after eating there is nausea, less often - vomiting.
Refusal to eat and drink.
You may smell acetone on your breath.

If you do not apply in time medical assistance and not eliminate the provoking factors, the situation may worsen and lead to an acetone crisis.

What is acetonemic syndrome (AS)

Acetonemic syndrome in a child - exclusively childhood disease. Can not be medical diagnosis"Acetonemic syndrome in adults". You can also find a number of synonyms for this disease: acetonemic vomiting, acetonemic crisis, non-diabetic ketoacidosis and others. Acetonemic syndrome is a complex of symptoms that appear when the level of acetone in the urine increases.

The following symptoms may appear:

frequent and profuse vomiting;
vomiting is repeated at regular intervals, with the same intensity;
episodes of vomiting can be observed from several hours to several days;
the presence of bile and mucus in the vomit, less often - blood;
severe dehydration of the body and its signs in the form of dryness of the tongue and skin, sunken eyes;
cardiopalmus;
deep noisy breathing;
lethargy;
photophobia;
signs of intoxication: pallor of the skin (but the cheeks turn red at the same time), weakness, the temperature may rise even more or remain within the subfebrile range;
drowsiness, convulsions, risk of coma;
strong smell of acetone in exhaled air, in vomit;
stomach ache.

To characterize the acetone syndrome, the term "ketosis" is used, which includes prolonged nausea, frequent vomiting, refusal to eat, lethargy, dehydration, fever. Ketosis can be observed for several days, increase and manifest itself with greater intensity.

AC types

Primary AS. It is also called idiopathic, that is, arising for unknown reasons, without damage to organs and systems, without various pathologies. Primary AS is also called "nervous-arthritic diathesis", which is not related to diseases and is associated with the type of constitution of the child, his nervous system, and individual sensitivity to external stimuli. Usually these are easily vulnerable, excitable, active, emotional, nervous children. They have metabolic disorders, appetite, digestive disorders, underweight, speech and sleep disorders, and nocturnal enuresis is often noted.
Secondary AS. Occurs against the background of other diseases. It can like intestinal infections, and a typical SARS, influenza, tonsillitis with signs of intoxication, diseases of the digestive system, kidneys, pancreas and thyroid gland, liver.

If acetone appears not only in the urine, but also in saliva or vomit, this can be an alarm signal and indicates a high level of acetone in the blood. The most serious and most probable cause acetonemia may be diabetes mellitus. To exclude this disease, the doctor prescribes a blood test for sugar. If it is known that the acetone crisis arose against the background of diabetes, you need to measure the sugar level, immediately call an ambulance.

How to treat acetonemic syndrome

Treatment of acetonemic syndrome in children is conditionally divided into two stages. First of all, it is necessary to stop the acetone crisis, and then take measures to eliminate the cause of the increase in acetone in the blood, and as a result, in the urine.

How to give first aid to a child

First aid should be given to as soon as possible, otherwise a strong toxic poisoning, damage to the central nervous system with convulsions and coma, severe dehydration. In the treatment of acetonemic syndrome at home, a number of measures must be taken. Which ones?

Removal from the body of acetone. Cleansing enemas, gastric lavage (according to the condition and age of the child). Sorbents for removing toxins are also recommended: Polysorb, Enterosgel, Sorbogel, Filtrum STI, Uvesorb and others.
Dehydration warning. The child needs plentiful drink. In order not to cause repeated vomiting, you need to drink in small sips (about 10 ml), with breaks of 10 minutes. If the child is small, naughty, refuses to take liquid, you need to solder it from the syringe, slowly directing the jet to the cheek. What can a child drink? Mineral water should be non-carbonated and alkaline. In this situation, rehydration solutions are indispensable, which restore energy and electrolyte balance. Solutions are prepared from pharmaceutical powders: Oralit, Gastrolit, Hydrovit, Regidron and others. The daily volume of fluid required during the period of dehydration is 120 mg/kg.
Replenishment of the body with glucose. In addition to liquid, the body requires glucose, so sweet drinks are indicated: for example, sweet tea, dried fruit compote, glucose solution. Drinking should not be very sweet, it should be alternated with mineral water. If the child does not vomit, and also has an appetite, you can offer a baked apple, rice water, mashed potatoes on the water, oatmeal without oil. Food should be warm, served in a small volume. When vomiting, it is strictly forbidden to feed.
What is important to know. Even if the child had a single case of an acetone crisis, you need to take a blood test for sugar. If a child is known to have diabetes, an ambulance should be called immediately.

If it was possible to stop the acetone crisis, it is imperative to show the child to the doctor and undergo a series of examinations: ultrasound of the pancreas and liver, general and biochemical analysis blood and urine.

When is inpatient treatment required?

If the treatment of acetonemic vomiting in children at home does not lead to improvement, if it is not possible to solder, and the symptoms worsen, hospitalization is recommended. Treatment of acetonemic syndrome in the hospital is also carried out in children infancy who are at a much higher risk of dehydration. In the diagnosis of "diabetes mellitus" is also recommended hospital treatment and strict medical supervision. How is acetonemic syndrome treated in a hospital setting?

infusion therapy. Glucose-salt solutions are administered intravenously with large fluid losses and severe dehydration.
Antispasmodics. They are prescribed for severe spastic pains in the abdomen.
Antiemetics. Introduced by injection, if vomiting is profuse and indomitable.
Correction of the level of potassium. With a deficiency of potassium, injections of potassium chloride are prescribed.
Enzyme therapy. It is prescribed for violation of the secretion of the pancreas.
Heart drugs. According to indications.

Nutrition and lifestyle

To prevent acetonemic syndrome and prevent its recurrence, you should pay attention to the diet and daily routine of the child.

Diet. Two extremes in nutrition should be avoided: overeating and starvation. AT acute period need to eat food plant origin, carbohydrate-rich cereals, vegetable soups, low-fat sour-milk products (kefir, yogurt), non-bread cookies, crackers, baked vegetables and fruits. Sweet should be present in the diet, but within reasonable limits. It is better to give jam and honey (if there is no allergy).
What can't be eaten? It is necessary to remove from the diet fatty foods of animal origin, broths, marinades, smoked meats, offal, fatty dairy products (sour cream, cream), as well as oranges, tomatoes, chocolate. You also need to exclude fast food products, carbonated drinks, any food saturated with dyes, flavor enhancers, etc.
Lifestyle and psycho-emotional state. It is necessary to reconsider not only the diet, but also the way of life. How much the child sleeps, how much time he spends outdoors, how much he sits at the computer, what physical and mental stress he has, is there any conflict with peers, does he live in permanent depression- all these questions will help to identify problems in relationships and adjust the daily routine. You can not completely exclude physical activity. For example, swimming, walking, cycling at a moderate pace will be useful for recurring acetonemic syndrome.

Hardening procedures are also a good prevention of acetonemia: dousing, rubbing, cold and hot shower. It is also important that the child has good mood more positive moments in life.

Possible Complications

Acetone in children in the urine is most often found before 12 years of age. Later, relapses do not recur, this is due to the maturity of the enzyme system. But even in this case, the child may be on dispensary registration for some time. Against the background of recurring acetonemic syndrome, complications may occur: increased arterial pressure, damage to the kidneys and liver, diseases of the joints, biliary tract, metabolic disorders, diabetes mellitus and other diseases.

Test strips can be used to systematically monitor acetone in urine. They must be in home first aid kit emergency care if the child has suffered several acetonemic crises.

High acetone in the urine of a child can be associated with lifestyle and nutrition, so it stops quite easily when the provoking factors are eliminated. But it can also cause serious illnesses primarily diabetes. Even a single case of acetonemic syndrome requires a mandatory visit to a doctor and an additional examination.

The presence of acetone in the blood of a baby is a signal that indicates a violation of health. Parents should understand that in some cases this is a sign of a short-term disorder. However, acetone may indicate hazardous chronic diseases child requiring immediate action. In any case, such a symptom suggests that the baby must be shown to the doctor to establish accurate diagnosis. This will help prevent a number of complications and stabilize the state of health. Parents should be aware of the cases in which acetone appears in the blood, how to independently detect this symptom. It should be understood that the baby's blood changes its chemical composition at the slightest change that affects the body. medical science has long studied and described such a condition as an acetone crisis.

Normally, there should be no acetone in the blood of a child. If a malfunction occurs in the body, then acetone is detected in the urine and blood tests. This condition is called acetone crisis or acetonemia. It is worth noting that it can develop very quickly. The kid suddenly becomes lethargic, complains about bad feeling. However, this violation is typical only for childhood. Elevated blood levels of two substances, acetoacetic acid and acetone, lead to acetonemia. They are also called ketone bodies. This occurs with various metabolic disorders in the child's body.

Acetone and acetoacetic acid are produced in the liver of every person. With the development of the disease, the level of these substances increases, which has Negative influence on the state of the central nervous system, as well as other organs and systems of the baby.

Doctors identify many reasons for the development of an acetone crisis. Most often, the disorder develops against the background of an unbalanced and junk food in which the child's diet contains a large number of fatty food.

The functioning of the liver is disrupted, which cannot produce enough of the substances necessary for the digestion and assimilation of fatty foods.

In addition, the main causes of acetone in the blood include the following groups of diseases:

endocrine;
somatic;
tumor;
infectious;
affecting the central nervous system.

In some cases, increased acetone in the baby's blood can be the cause of irregular meals. It is very important that the child's body receives food five times a day at a strictly set time. Very often, acetonemia develops as side effect with such infectious and viral diseases as SARS, bronchitis, pneumonia. If increased acetone in the blood occurred during a trip, then this indicates that an infection has entered the body, against which the child's body has not developed immunity. Often, the acetone crisis becomes an unpleasant companion during a family vacation.

Children's diabetes mellitus also contributes to the development of acetonemia, since metabolic processes are disturbed in the body. In addition, problems with gastrointestinal tract and neuro-arthritic diathesis increase the risk of such an unpleasant disorder. Various disorders of the nervous system, which include overwork, chronic fatigue, large mental and mental stress, can also provoke an acetone crisis. It is very important to identify the cause of the disorder in a timely manner in order to undergo appropriate treatment and prevent recurrence.

The phenomenon of acetonemia is quite common. Basically, this disorder develops in children aged 1 to 12 years. Wherein average age patients is 5 years old. Only 4 to 6% of babies have suffered this condition at least once in their lives. For this reason, it is so important for parents to find out as much information as possible in order to take the right measures, if necessary, that will keep their child healthy and prevent complications.

The main symptoms of the disease

The main symptom of a child's illness is ketosis. This condition begins with sudden onset of nausea and vomiting. At the same time, the baby complains of a feeling of pain in the abdomen (especially in the navel), sharp deterioration appetite. Often he refuses even to drink. The child's mood changes. He may become lethargic or nervous. At the same time, parents may notice the smell of acetone that has appeared in the urine. Some compare it to how rotten apples smell. For some, this smell is barely perceptible, while for others it is heard at a fairly large distance. It should be noted that vomiting can periodically appear and disappear. These symptoms can last up to 5 days.

The deterioration of the child's health is evidenced by the dryness of the mucous membranes and skin, which develops as a result of gradual dehydration. characteristic feature acetone crisis is a sharp decline body weight, a sunken look and a characteristic blush that should alert parents. The baby does not look healthy, because the blush gives a sickly look.

It is very important to try by all means to prevent dehydration, which develops in babies much faster than in adults. It poses the greatest threat to a growing organism. The lower the body weight, the more dangerous dehydration.

Often, with an acetone crisis, body temperature rises, which is also one of the main symptoms of an increase in acetone in the child's blood. It can rise to 38.5 degrees. In this case, it is very important to provide qualified medical care. Parents should understand that all the symptoms described are of an increasing nature. An acetone crisis is not a disorder that a child's body can cope with on its own.

To help parents make a preliminary diagnosis, there are special test strips for the determination of ketones in the urine. They can be used at home. It is important to understand that the test strips are designed only so that parents can make a preliminary diagnosis and contact the doctor in a timely manner to confirm it and prescribe treatment.

Treatment of acetone crisis

In the past, all treatments were limited to a doctor prescribing a diet that involved the rejection of food with high content fats. This recommendation has not lost its relevance today. It is advisable to compose the child's diet in such a way that during the treatment period it consists mainly of carbohydrate foods. It is much easier for the body to digest. The second rule is the appointment of drugs that will prevent dehydration. It is necessary to water the baby with a solution of Regidron or its analogues. Given medicine normalizes water-salt exchange in the body. In this case, you can still use a glucose solution, the concentration of which is 5%. Such treatment should be under the supervision of a physician.

All measures should be aimed at cleansing the body of acetone and acetoacetic acid. To do this, it is important to increase the level of glucose. At home, you can solder the baby with sweet tea, dried fruit compote, rosehip broth. In this case, the drink should be given in small portions. If the baby drinks about 100 milliliters of liquid at a time, this can again provoke vomiting. Try to give your baby first a teaspoon, and then a tablespoon of tea, compote with an interval of about 1 hour.

In severe cases, you can give the baby an enema, which will help cleanse the body of harmful substances. Nice results gives an alternation of sweet drink with table mineral water, which contains various micro and macro elements. Among the drugs that can alleviate the condition of the child, the following can be distinguished:

Smecta;
Enterosgel;
Polysorb;
Filtrum.

We recommend contacting a qualified doctor at the first symptoms of an acetone crisis. If the baby does not receive medical attention in a timely manner, this can lead to an even greater increase in the level of acetone. In this case, hospitalization is required for infusion therapy. It involves intravenous infusion medicinal solutions, which is always a great stress for the physical and psychological state child.

Acetone in the blood is the cause of extremely dangerous state called the acetone crisis. It can develop suddenly as a complication of the most various diseases. To determine the level of acetone in the body, you can use special test strips.