Hyponatremia in children with respiratory infections: a cross-sectional analysis of a cohort of 3938 patients

Park, Sung Won; Shin, Son Moon; Jeong, Moonsun; Cho, Dong Hee; Lee, Keum Hwa; Eisenhut, Michael; Kronbichler, Andreas; Moritz, Michael L.; Shin, Jae Il

doi:10.1038/s41598-018-34703-1

Cited by 26 publications

(38 citation statements)

References 36 publications

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“…The marked increase in plasma IL-6 and TNF-α in IVIG-resistant infants compared with IVIG-responsive patients ( 31 , 32 ) may explain the significant hyponatremia in IVIG nonresponders. In our study, it was observed that hyponatremia and hypoalbuminemia correlated with an increase in acute phase reactants in IVIG-resistant patients ( 33 - 37 ).…”

Section: Discussionmentioning

confidence: 48%

How useful are Kawasaki disease risk scoring systems to the Turkish population?

2020

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Objective: Kawasaki disease (KD) is the most common cause of coronary artery aneurysm (CAA) in children. The available risk scores to predict intravenous immunoglobulin (IVIG) resistance and CAA were developed in Asian populations in whom their effectiveness has been proven, but data on non-Asian children are limited. This study aimed to evaluate the ability of 5 risk scoring systems to predict IVIG resistance and CAA in Turkey patients with KD. Methods: Patients with KD were retrospectively evaluated with clinical, laboratory, and echocardiographic findings. Data analyses were performed in 5 scoring systems (Harada, Kobayashi, Egami, Formosa, and Sano). Results: A total of 259 patients (Male: Female, 1.7) were treated for KD in our hospital. The mean age of diagnosis in patients with KD, CAA, and IVIG resistance were 3.31, 2.19, and 2.06, respectively. CAA development and IVIG resistance were seen in 11.6% and 12.3% of cases, respectively. IVIG resistance was detected in 35.6% of patients with CAA. In our study, 5 risk scoring systems were applied to our patients. ROC analysis results were found highest in Kobayashi scoring system for IVIG resistance (AUC, 0.864) and in Harada scoring system for CAA development (AUC, 0.727). Conclusion: Harada score was significant in predicting CAA risk, and Kobayashi score was significant in predicting the risk of developing IVIG resistance. It is necessary to determine more specific and sensitive risk scores that increase the risk of IVIG resistance and the development of CAA in Turkey.

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Section: Discussionmentioning

confidence: 48%

How useful are Kawasaki disease risk scoring systems to the Turkish population?

2020

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“…However, some observations suggest that hypernatremia is currently less common than hyponatremia [1–3]. The latter electrolyte abnormality has sometimes been documented also in children with further community-acquired diseases, such as lower respiratory tract infections [4, 5].…”

Section: Introductionmentioning

confidence: 99%

Hyponatremia in infants with community-acquired infections on hospital admission

et al. 2019

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Acute moderate to severe gastroenteritis is traditionally associated with hypernatremia but recent observations suggest that hypernatremia is currently less common than hyponatremia. The latter has sometimes been documented also in children with acute community-acquired diseases, such as bronchiolitis and pyelonephritis. We investigated the prevalence of dysnatremia in children with acute moderate severe gastroenteritis, bronchiolitis and pyelonephritis. This prospective observational study included 400 consecutive previously healthy infants ≥4 weeks to ≤24 months of age (232 males and 168 females): 160 with gastroenteritis and relevant dehydration, 160 with moderate-severe bronchiolitis and 80 with pyelonephritis admitted to our emergency department between 2009 and 2017. Circulating sodium was determined by means of direct potentiometry. For analysis, the Kruskal-Wallis test and the Fisher’s exact test were used. Hyponatremia was found in 214 of the 400 patients. It was common in gastroenteritis (43%) and significantly more frequent in bronchiolitis (57%) and pyelonephritis (68%). Patients with hyponatremia were significantly younger than those without hyponatremia (3.9 [1.6–13] versus 7.5 [3.4–14] months). The gender ratio was similar in children with and without hyponatremia. Hyponatremia was associated with further metabolic abnormalities (hypokalemia, hyperkalemia, metabolic acidosis or metabolic alkalosis) in gastroenteritis (71%) and pyelonephritis (54%), and always isolated in bronchiolitis. In conclusion, hyponatremia is common at presentation among previously healthy infants with gastroenteritis, bronchiolitis or pyelonephritis. These data have relevant consequences for the nutrition and rehydration management in these conditions.

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“…These findings are similar to results derived from present study(38).A retrospective cross sectional study done by Lavagno et.al in Cheil General Hospital and Women's Health Care Center, Seoul South Korea in 3938 children with respiratory infections between March, 2011, and February, 2014 is also consistent with present study. In this study, the duration of hospital stay in children with hyponatremia was 4.5±1.5 days and4.3±1.5 days in children with normal sodium ( p=0.020)(39).Another study was done by Kaneko et.al in Department of Pediatrics, Juntendo University Urayasu Hospital,Chiba, Japan. Medical record of 138 children was reviewed retrospectively in the year 2004.Objective of the study was to found the relation of hyponatremia and duration of hospital stay.…”

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confidence: 46%

Hyponatremia As A Predictor Of Adverse Outcome In Children With Severe Lower Respiratory Tract Infection In Tribhuvan University Teaching Hospital (Tuth), Nepal

Lamichhane¹,

Shrestha²,

Bajracharya³

et al. 2020

Preprint

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Background Lower respiratory tract infection (LRTI) is one of the major causes of mortality in children with estimated 1 million deaths every year. Hyponatremia is the most common electrolyte abnormality seen in LRTI. Objective To find association of hyponatremia (serum sodium<135meq/l) with severe LRTI. Design Prospective cross sectional study Settings Pediatric Emergency, Ward and Pediatric Intensive Care Unit of Tribhuvan University Teaching Hospital(TUTH) Subjects Children between 2 months to 16 years presenting with cough for less than 3 weeks, fast breathing and chest indrawing. Methods Children between 2 month to 16 years of age having cough, fast breathing and chest indrawing admitted in emergency, ward or PICU of TUTH were screened and among them, children having pediatric respiratory severity score of 4-5 were enrolled in the study. Serum sodium was sent during admission and collected within 2 hours. Daily follow up was done to find need of respiratory support, duration to resolve hypoxia, total duration in hospital and final outcome of patient. Statistical test applied were Chi-square test and Fisher exact test. Results 47.5% of study population had hyponatremia, of whom 65.79% had mild hyponatremia 26.31% had moderate and 7.89%had severe hyponatremia. Association of hyponatremia with need of non rebreathing face mask (p=0.001), ventilatio r (p=0.009), duration of hospital stay (p=0.047) were significant. The study also found the association of severity of hyponatremia with need of non rebreathing facemask (p=0.001),ventilator (p=0.01), outcome (p=0.001), duration of stay (0.002). Mean time to resolve hypoxia in children with hyponatremia (4.5 days) was longer compared to normal sodium (2.58 days). Four patients died during the study period and all of them had hyponatremia.

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Hyponatremia in children with respiratory infections: a cross-sectional analysis of a cohort of 3938 patients

Cited by 26 publications

References 36 publications

How useful are Kawasaki disease risk scoring systems to the Turkish population?

How useful are Kawasaki disease risk scoring systems to the Turkish population?

Hyponatremia in infants with community-acquired infections on hospital admission

Hyponatremia As A Predictor Of Adverse Outcome In Children With Severe Lower Respiratory Tract Infection In Tribhuvan University Teaching Hospital (Tuth), Nepal

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