Hypovolemia in children

Its the common pathology that is coexistent with most deaths all over the world. Hypovolemia that is missed or undertreated gets into vicious cycle of reduced urine output and renal hypofunction that can never be improved without adding fluids.
Remember high fluids intake can eb washed of with diuretics but low fluids with vicious inotropic support can be killing.
Also hyperkalemia ie common coexistent terminal electrolyte issue around death.  Potassium supplements especially fruits often are needed for only dehydrated kids with low potassium.. but uts always better we treat them with hospital support than with potassium.
But fruit juices especially coconut juices can surely do harm for patients especially with kidney related issues who are at risk of developing hype kalemia.
Moral is... reserve fruits and juices for healed patients and not the sick ones.
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ERG or VEP?

Often blindness is associated in neuro metabolic diseases apart from hyperbarix oxygen damage in new borns to ocular infection s.

We follow retina assessment protocol for suspected retinal detachment in nicu or ventilator graduates..

For optic atrophy no obvious tests but a repeat check after three months following a heavy dose steroids helps doc call it irreversible.

In extensive retinal disease both ERG that is electroretinogram and VEP are likely to be abnormal.
In retinitis pigmentosa as in storage diseases ERG may be affected though VEP may be preserved.

Vice versa in macular degeneration VEP is affected and ERG May be intact.

For diseases like galactosemia and wilsons monitoring lens ofr cataract is important so is in steroid toxicity.