Hospital-acquired hyponatremia in pediatric intensive care unit

Sachdev, Anil; Pandharikar, Nagaraj; Gupta, Dhiren; Gupta, Neeraj; Gupta, Suresh; Venkatraman, Shekhar T

doi:10.4103/ijccm.ijccm_131_17

Cited by 10 publications

(7 citation statements)

References 27 publications

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“…However, the length of stay was increased in all other categories in patients with electrolyte imbalance (Table-III). This was consistent with studies conducted in the past 5,11,12. This makes electrolyte imbalance a major drain on limited health resources of poor and developing countries.…”

Section: Discussionsupporting

confidence: 91%

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Electrolyte imbalance in critically ill paediatric patients

et al. 2019

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Objective: To determine the frequency and outcome of electrolyte imbalance in seriously ill children admitted in Paediatric Intensive Care Unit (PICU) of a public sector hospital in Karachi. Methods: All children between the ages of one month to 12 years admitted in PICU from May 2017 to October 2017 were included. Blood samples were drawn to determine the baseline sodium, potassium, calcium, magnesium and phosphorous and followed 24 hourly or earlier, if needed (Those who had imbalance at admission or on subsequent repeat labs as per protocol). Results: A total of 101 children were included in the study. Electrolyte imbalance was seen in 84%. A single electrolyte imbalance was noted in 30.58%. Hypocalcemia was the most frequent abnormality noted in 57.6%. Among the total expiries during the study period 91% had electrolyte imbalance. Mortality within 48 hours and duration of stay was also increased in these patients. Conclusion: Electrolyte imbalance is an important prognostic indicator in critically ill patients. doi: https://doi.org/10.12669/pjms.35.4.286 How to cite this:Naseem F, Saleem A, Mahar IA, Arif F. Electrolyte imbalance in critically ill paediatric patients. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.286 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 91%

“…Majority had respiratory (30.69%), neurological (25.74%) and infective/sepsis (19.80%) etiology as noted in previous studies 3,10,11. The reason for less number of gastrointestinal cases (3.96%) could be the initial stabilization in ER and later shifting to ward upon improvement thus bypassing the PICU stay.…”

Section: Discussionmentioning

confidence: 63%

Electrolyte imbalance in critically ill paediatric patients

et al. 2019

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“…Most studies predict a longer hospital stay in hyponatremic patients [6,20,23]. Consistent with the literature, the length of hospital stay of normonatremic patients was significantly lower in our study compared to the other two groups (p = 0.008).…”

Section: Discussionsupporting

confidence: 91%

“…Hyponatremia is a serum sodium (Na) level below 135 mEq/L. According to the published data, the incidence of hyponatremia in pediatric patients can increase up to 60% at admission to the hospital [6,7]. The incidence of Hospital-acquired Hyponatremia (HAH) in children is 19.6% [6].…”

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confidence: 99%

“…According to the published data, the incidence of hyponatremia in pediatric patients can increase up to 60% at admission to the hospital [6,7]. The incidence of Hospital-acquired Hyponatremia (HAH) in children is 19.6% [6]. Symptoms of hyponatremia can range from non-specific findings such as restlessness, agitation, headache, and weakness that may be overlooked to serious neurological symptoms such as seizures, confusion, and coma [7].…”

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confidence: 99%

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The severity of hyponatremia worsens the outcome in pediatric intensive care patients

OTO,

ERDOĞAN,

BOŞNAK

2023

The European Research Journal

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Objectives: Hyponatremia is known to increase mortality and morbidity in adult patients. However, the significance of hyponatremia in critically ill pediatric patients is unknown, unlike in adults. We tried to determine the prevalance of hyponatremia in critically ill children and whether the severity of hyponatremia contributes to hospital stay and mortality. Methods: The results of 190 patients who met the inclusion criteria and were admitted to the pediatric intensive care unit between April 2014 and April 2017 were analyzed. Results: Eighty-six (45.3%) patients developed hyponatremia at the time of hospitalization, and Hospital‑Acquired Hyponatremia (HAH) developed in 46 (24.2%) patients during the hospitalization. Fifty-eight (30.5%) patients were normonatremic. The patients in the HAH group were significantly more septic (p = 0.015). The duration of intensive care hospitalization was significantly longer in the HAH group (p < 0.001) and significantly less in the normonatremic group (p = 0.008). Total mortality was 41% (n = 78). There was no difference between the groups regarding mortality (p = 0.4). However, the degree of hyponatremia was associated with mortality. Mortality was 24.1% in mildly hyponatremic patients, 45.6% in moderate patients, and 58.8% in severe patients (OR: 2.636, 95% CI: 1.189-5.842; OR: 4.490, 95% CI:1.439-14.008, p = 0.01). We discovered that as hyponatremia severity increased, so did the length of stay in the intensive care unit, the need for invasive ventilation, and the need for vasoactive drugs (p = 0.009, p = 0.018, and p = 0.006, respectively). Conclusions: Unlike adults, the prognostic value of hyponatremia in terms of mortality has not been determined in critically ill children. However, as the severity of hyponatremia increased, it was seen that the length of stay in the intensive care unit and mortality increased.

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