Effects of Metabolic Disturbances in Infants 161 



may be threatened either by high urine volumes or, in the 

 case of renal inadequacy, by uraemia. 



In summary, the mechanisms defending body fluid equili- 

 brium in the infant are more easily broken down owing to the 

 water reserves being low in relation to the high metabolic 

 rate and "strained" circulation. In circumstances of shortage 

 this small water pool is quickly exhausted, and it is also 

 easily flooded by loads which, in terms of body surface, are 

 equal to those for adults. By decreasing the small plasma pool 

 rapidly, water losses lead to slowing down of circulation. 

 Owing to the rapidly decreasing renal clearances, as well as 

 the high metabolic rate producing solutes at great speed, the 

 relatively small water pool cannot then keep up its constancy. 

 Deterioration is accelerated by arrested growth. 



In conclusion a particular type of dehydration in which the 

 infant seems to be in a somewhat less difficult position than 

 the adult may be mentioned. In infantile pyloric stenosis, a 

 condition in which starvation and dehydration develop 

 together, a sharp decrease of about 50 per cent in oxy- 

 gen consumption has been observed by Varga (1957). We 

 have found that this diminution in oxygen requirements 

 protects against stagnating anoxia brought about by the 

 slowing down of circulation due to dehydration (Kerpel- 

 Fronius e^ aZ., 1951). A low metabolic rate will most probably 

 also diminish obligatory water expenditures and thus delay 

 the progress of dehydration. Since the metabolic rate de- 

 creases less in the semi-starved adult (Keys et ah, 1950), the 

 infant may possibly be more resistant to dehydration when 

 he is already suffering from starvation than an adult under 

 similar circumstances. 



REFERENCES 



American Academy of Pediatrics. (1957). Report of Commission on 



Nutrition. Pediatrics, Springfield, 19, 339. 

 CsAPd, J., and Kerpel-Fronius, E. (1933). Mschr. Kinderheilk., 58, 1. 

 Kerpel-Fronius, E. (1933). Z. ges. exp. Med., 90, 676. 

 Kerpel-Fronius, E., and KovAch, I. (1948). Pediatrics, Springfield, 2, 



21. 



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