Hypernatraemia: diagnosis and management

Haycock, G B

doi:10.1136/adc.2004.066928

Cited by 8 publications

(12 citation statements)

References 45 publications

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“…Uncertainty surrounds the maximum desirable rate of fall of serum sodium after slow onset hypernatraemia 18 19. Although many of our cases exceed recommended rates of fall (typically quoted at 12 mmol/l per 24 h), no complications of rehydration were observed in this study.…”

Section: Discussionmentioning

confidence: 56%

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Severe neonatal hypernatraemia: a population based study

Oddie

Craven

Deakin

et al. 2013

Arch Dis Child Fetal Neonatal Ed

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AIMS: To describe incidence, presentation, treatment and short term outcomes of severe neonatal hypernatraemia (SNH, sodium >/=160 mmol/l). METHODS: Prospective, population based surveillance study over 13 months using the British Paediatric Surveillance Unit. Cases were >33 weeks gestation at birth, fed breast or formula milk and <28 days of age at presentation. RESULTS: Of 62 cases of SNH reported (7, 95% CI 5.4 to 9.0 per 1 00 000 live births), 61 mothers had intended to achieve exclusive breast feeding. Infants presented at median day 6 (range 2-17) with median weight loss of 19.5% (range 8.9-30.9). 12 had jaundice and 57 weight loss as a presenting feature. 58 presented with weight loss >/=15%. 25 babies had not stooled in the 24 h prior to admission. Serum sodium fell by median 12.9 mmol/l per 24 h (range 0-30). No baby died, had seizures or coma or was treated with dialysis or a central line. At discharge, babies had regained 11% of initial birth weight after a median admission of 5 (range 2-14) days. 10 were exclusively breast fed on discharge from hospital. CONCLUSIONS: Neonatal hypernatraemia at this level, in this population, is strongly associated with weight loss. It occurs almost exclusively after attempts to initiate breast feeding, occurs uncommonly and does not appear to be associated with serious short term morbidities, beyond admission to hospital

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Section: Discussionmentioning

confidence: 56%

“…It is thus clearly distinguished from salt poisoning where weight loss is not a feature 18. The weight loss, and inhospital gain after treatment, in our cases is striking and illustrates missed opportunities for prevention or early intervention.…”

Section: Discussionmentioning

confidence: 63%

Severe neonatal hypernatraemia: a population based study

Oddie

Craven

Deakin

et al. 2013

Arch Dis Child Fetal Neonatal Ed

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“…Hipernatremia. Diagnóstico diferencial y tratamiento 29,30 Definida como un Na + plasmático > 145 meq/l. la respuesta normal a la hipernatremia es un aumento en la liberación de ADH, con ahorro renal de agua (con una orina concentrada, cH 2 o e : negativo), y aparición de sed, lo que restablece la osmolalidad a límites normales.…”

Section: Principios Generales Del Tratamiento De La Hiponatremiaunclassified

Bases fisiopatológicas de los trastornos del sodio en pediatría

2014

Rev. chil. pediatr.

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Dysnatremia is among the most common electrolyte disorders in clinical medicine and its improper management can have serious consequences associated with increased morbidity and mortality of patients. The aim of this study is to update the pathophysiology of dysnatremia and review some simple clinical and laboratory tools, easy to interpret, that allow us to make a quick and simple approach. Dysnatremia involves water balance disorders. Water balance is directly related to osmoregulation. There are mechanisms to maintain plasma osmolality control; which are triggered by 1-2% changes. Hypothalamic osmoreceptors detect changes in plasma osmolality, regulating the secretion of Antidiuretic Hormone (ADH), which travels to the kidneys resulting in more water being reabsorbed into the blood; therefore, the kidney is the main regulator of water balance. When a patient is suffering dysnatremia, it is important to assess how his ADH-renal axis is working. There are causes of this condition easy to identify, however, to differentiate a syndrome of inappropriate ADH secretion from cerebral salt-wasting syndrome is often more difficult. In the case of hypernatremia, to suspect insipidus diabetes and to differentiate its either central or nephrogenic origin is essential for its management. In conclusion, dysnatremia management requires pathophysiologic knowledge of its development in order to make an accurate diagnosis and appropriate treatment, avoiding errors that may endanger the health of our patients.

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“…Release of vasopressin occurs when the effective blood osmolality exceeds 275-280 mosmol/kg H 2 O and results in maximally concentrated urine when the effective blood osmolality exceeds 290-295 mosmol/kg H 2 O [3,5]. Thirst, the second line of defense, provides a further protection against hypernatremia and increased effective osmolality.…”

Section: Hypernatremiamentioning

confidence: 99%

Body fluids and salt metabolism - Part II

et al. 2010

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There is a high frequency of diarrhea and vomiting in childhood. As a consequence the focus of the present review is to recognize the different body fluid compartments, to clinically assess the degree of dehydration, to know how the equilibrium between extracellular fluid and intracellular fluid is maintained, to calculate the effective blood osmolality and discuss both parenteral fluid maintenance and replacement.

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Hypernatraemia: diagnosis and management

Cited by 8 publications

References 45 publications

Severe neonatal hypernatraemia: a population based study

Severe neonatal hypernatraemia: a population based study

Bases fisiopatológicas de los trastornos del sodio en pediatría

Body fluids and salt metabolism - Part II

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