Hyponatraemia in cases of children with pneumonia

Abstract

IntroductionHyponatraemia is the most common electrolyte imbalance seen in clinical practice, and a common laboratory finding in children with community-acquired pneumonia (CAP). This study aimed to identify the incidence of hyponatraemia in cases of CAP, to find predictive tools in order to classify the severity and outcome of CAP and to explore possible differences of clinical importance between the two sexes.Material and methodsThe medical files of 54 children (66.4% males), 4.67 ±2.88 years old, were retro-prospectively reviewed.Results35/54 (64.8%) children with pneumonia had normal values of sodium at admission, 18/54 (33.3%) had mild hyponatraemia and 1 child (1.9%) moderate hyponatraemia. Increased heart rhythm and tachypnoea at admission were correlated with lower values of sodium (z= −2.664, p = 0.007 and z = −1.705, p = 0.089 respectively). No differences were found between the two sexes concerning the characteristics of pneumonia or the range of sodium in serum at admission. A correlation was found between sodium admission values and: a) C-reactive protein (p = 0.000), and b) leukocyte count (p = 0.006). Sedimentation rate (p = 0.021) was also considered as a possible risk factor affecting the value of sodium at admission to hospital. Finally, a negative association was also observed between the degree of hyponatraemia and the duration of hospitalization (z = −3.398, p = 0.001).ConclusionsAlthough studies in larger population groups are needed, in our study increased heart rhythm, tachypnoea, leucocyte count, C-reactive protein, and also erythrocyte sedimentation rate could be considered as possible risk factors influencing the degree of hyponatraemia, and thus the outcome of hospitalized children with CAP.

Correlation of Hyponatraemia in Children With Lower Respiratory Tract Infection - An Institutional Observational Study

“…(8) The analysis of two studies in children with pneumonia has shown a significant association between the presence of hyponatraemia and elevated levels of non-specific inflammatory markers. (2,10) Such correlation was not observed in our study. Although, in the previous two studies, it was reported that hyponatraemia seemed to be associated with the longer hospitalisation period and a prolonged duration of fever, there was no such relationship in our study.…”

“…Although, in the previous two studies, it was reported that hyponatraemia seemed to be associated with the longer hospitalisation period and a prolonged duration of fever, there was no such relationship in our study. (2,10) Studies have also demonstrated that respiratory compromise is a comorbid factor in patients with hyponatraemia markedly increasing the risk of death from pneumonia. The underlying mechanism is probably hypoxia, a major risk factor for the development of hyponatraemic encephalopathy.…”

Hyponatremia in Children Requiring Hospitalization

“…46.5% children with pneumonia had hyponatremia in our study. In another study, mild hyponatremia was found in 33.3% of hyponatremia and moderate hyponatremia was found in 1.9% of children with pneumonia [6]. In a recent published literature by Shah GS et al hyponatremia was present in 56% of children presenting with diarrhea [7], it was much higher than present study where 37.7% of children with diarrhea had hyponatremia.…”

Hyponatremia in Children Hospitalized due to Pneumonia

“…We found HN in 33.3 % cases of CAP. Sakellaropoulou et al (2010) determined HN to occur in 35.2 % of children with CAP, while Don et al (2008) found 45 % of patients with pneumonia to be hyponatremic. In both studies, the prevalence of mild forms of HN (96 and 92 %, respectively) is in line with our result of the 96 %.…”

“…In most cases, HN found in CAP is mild (Don et al 2008;Sakellaropoulou et al 2010). It has been suggested that HN is related with severity of pneumonia measured with serum inflammatory markers (Don et al 2008;Sakellaropoulou et al 2010), higher body temperature on admission (Don et al 2008), increased heart rate, tachypnea, longer hospital stay (Sakellaropoulou et al 2010), or with frequency of complications, higher mortality and longer duration of hospital stay (Singhi and Dhawan 1992). Any correlation between HN and type of radiological consolidation, or etiology of CAP has not been found (Don et al 2008).…”