Hyponatremia and Its Association with the Neurohormonal Activity and Adverse Clinical Events in Children and Young Adult Patients after the Fontan Operation

Ohuchi, Hideo; Negishi, Jun; S, Ono; Miyake, Akira; Toyota, Naoki; Tamaki, Wataru; Miyazaki, Aya

doi:10.1111/j.1747-0803.2011.00503.x

Cited by 13 publications

(3 citation statements)

References 29 publications

(55 reference statements)

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“…The majority of children in this study were hospitalized with cardiac disease (82%). The RAAS is activated both after cardiac surgery and with heart failure [ 15 , 16 , 17 , 18 ]. RAAS activation leads to absorption of urinary sodium and water in order to increase the circulating blood volume and thus improve organ perfusion pressure.…”

Section: Discussionmentioning

confidence: 99%

Enteral Sodium Chloride Supplementation and Fluid Balance in Children Receiving Diuretics

2022

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The use of sodium chloride (NaCl) supplementation in children being prescribed diuretics is controversial due to concerns that supplementation could lead to fluid retention. This is a single-center retrospective study in which fluid balance and diuretic dosing was examined in children prescribed enteral NaCl supplements for hyponatremia while receiving loop diuretics. The aim of this study was to determine whether significant fluid retention occurred with the addition of NaCl. Fifty-five patients with 68 events were studied. The median age was 5.2 months, and 82% were hospitalized for cardiac disease. Daily fluid balance the seven days prior to NaCl supplementation was lower than the seven days after, with measurement of: median 17 mL/kg/day (7–26) vs. 22 mL/kg/day (13–35) (p = 0.0003). There was no change in patient weight after supplementation (p = 0.63). There was no difference in the median loop diuretic dose before and after supplementation, with the diuretic dose in furosemide equivalents of 3.2 mL/kg/day (2.3–4.4) vs. 3.2 mL/kg/day (2.2–4.7) (p = 0.50). There was no difference in the proportion of patients receiving thiazide diuretics after supplementation (56% before vs. 50% after (p = 0.10)). NaCl supplementation in children receiving loop diuretics increased calculated fluid balance, but weight was unchanged, and this was not associated with an increase in diuretic needs, suggesting clinicians did not consider the increase in fluid balance to be clinically significant.

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Section: Discussionmentioning

confidence: 99%

Enteral Sodium Chloride Supplementation and Fluid Balance in Children Receiving Diuretics

2022

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“…Hyponatremia rate in Fontan patients was reported to be 30% due to high dose of diuretics, elevated renin activity and norepinephrine levels, and was reported as an independent predictor of unscheduled readmissions. Activation of the reninangiotensin-aldosteron system with negative sodium balance by the use of diuretics is the main cause of hyponatremia in pediatric patients [22] .…”

Section: Discussionmentioning

confidence: 99%

A Simple Predictive Factor for Mortality in Fontan Surgery: Serum Hypo-Osmolality

Özbek¹,

Tanrikulu²

2020

Braz J Cardiovasc Surg

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“…Homeostasis model assessment (HOMA) was used to assess insulin resistance (IR) [17], i.e., HOMA-IR = fasting plasma glucose (mg/dl) × fasting insulin (μU/ml)/405 (n = 284). In this study, hyponatremia was defined as a sodium level of ≤137 (mEq/L) [18].…”

Section: Plasma Uric Acid and Biochemical Variablesmentioning

confidence: 99%

Hyperuricemia reflects global Fontan pathophysiology and associates with morbidity and mortality in patients after the Fontan operation

Ohuchi¹,

Negishi²,

Hayama³

et al. 2015

International Journal of Cardiology

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Hyponatremia and Its Association with the Neurohormonal Activity and Adverse Clinical Events in Children and Young Adult Patients after the Fontan Operation

Abstract: Child and adult Fontan patients exhibited a high prevalence for HN that closely reflected some neurohumoral activation and predicted adverse clinical events, especially in adult Fontan patients.

Cited by 13 publications

References 29 publications

Enteral Sodium Chloride Supplementation and Fluid Balance in Children Receiving Diuretics

Enteral Sodium Chloride Supplementation and Fluid Balance in Children Receiving Diuretics

A Simple Predictive Factor for Mortality in Fontan Surgery: Serum Hypo-Osmolality

Hyperuricemia reflects global Fontan pathophysiology and associates with morbidity and mortality in patients after the Fontan operation

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