K Dunn1, W Butt. 1. Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia.
Abstract
OBJECTIVE: To determine the aetiology, symptoms and outcome of extreme sodium derangement in a paediatric inpatient population. METHODOLOGY: A retrospective study of children with extreme disturbance of their plasma sodium (> or = 165 mmol/L or < or = 115 mmol/L) admitted to a tertiary referral centre during a 72-month period. RESULTS: Twenty-seven cases of hypernatraemia and 21 of hyponatraemia were reviewed. Sodium disturbance developed after hospital admission in 27/57 cases (57%). Gastroenteritis was the most common cause of hypernatraemia (8/27; 30%), four of 27 (15%) had iatrogenic hypernatraemia. Water overload accounted for 8/21 (38%) cases of hyponatraemia. Neurologic symptoms occurred in 19/24 (79%) with hypernatraemia and in 11/19 (58%) with hyponatraemia. Ten (37%) with hypernatraemia and four (19%) with hyponatraemia died. A deterioration in functional status was seen in two patients with hypernatraemia. There was no apparent deterioration in the survivors with hyponatraemia. CONCLUSION: Extreme sodium disturbance often develops after admission to hospital and is caused by a variety of diseases and interventions. Neurologic symptoms are common and the mortality rate is high. The outcome in survivors is survivors is most likely to be dependent on the underlying disease process.
OBJECTIVE: To determine the aetiology, symptoms and outcome of extreme sodium derangement in a paediatric inpatient population. METHODOLOGY: A retrospective study of children with extreme disturbance of their plasma sodium (> or = 165 mmol/L or < or = 115 mmol/L) admitted to a tertiary referral centre during a 72-month period. RESULTS: Twenty-seven cases of hypernatraemia and 21 of hyponatraemia were reviewed. Sodium disturbance developed after hospital admission in 27/57 cases (57%). Gastroenteritis was the most common cause of hypernatraemia (8/27; 30%), four of 27 (15%) had iatrogenic hypernatraemia. Water overload accounted for 8/21 (38%) cases of hyponatraemia. Neurologic symptoms occurred in 19/24 (79%) with hypernatraemia and in 11/19 (58%) with hyponatraemia. Ten (37%) with hypernatraemia and four (19%) with hyponatraemia died. A deterioration in functional status was seen in two patients with hypernatraemia. There was no apparent deterioration in the survivors with hyponatraemia. CONCLUSION: Extreme sodium disturbance often develops after admission to hospital and is caused by a variety of diseases and interventions. Neurologic symptoms are common and the mortality rate is high. The outcome in survivors is survivors is most likely to be dependent on the underlying disease process.
Authors: Alexis A Topjian; Amber Stuart; Alyssa A Pabalan; Ashleigh Clair; Todd J Kilbaugh; Nicholas S Abend; Phillip B Storm; Robert A Berg; Jimmy W Huh; Stuart H Friess Journal: Pediatr Crit Care Med Date: 2014-11 Impact factor: 3.624
Authors: Peter Skippen; Robert Adderley; Mary Bennett; Arthur Cogswell; Norbert Froese; Mike Seear; David Wensley Journal: Paediatr Child Health Date: 2008-07 Impact factor: 2.253