Study of Hyponatremia in Paediatric Patients With Acute Lower Respiratory Tract Infection

Abstract

BACKGROUND Hyponatremia is one of the most common electrolyte abnormalities seen in paediatric intensive care unit. Common conditions associated with hyponatremia are pneumonia, acute meningitis, and Kawasaki disease. We wanted to estimate the frequency of hyponatremia and severity of hyponatremia with pneumonia grading. We also wanted to compare the occurrence of hyponatremia in pneumonia and other types of lower respiratory tract infection. METHODS This is a hospital based cross-sectional study of children aged 2 months to 5 years suffering from acute lower respiratory tract infection, admitted in PICU or paediatric ward. RESULTS 85 cases of lower respiratory tract infection (8%) of a total of 925 admissions during study period were included in the study. Out of the 85 cases of lower respiratory tract infection, 59 (69.4%) had pneumonia, 16 (18.8%) had bronchiolitis, 8 (9.4%) had wheeze associated lower respiratory tract infection and 2 (2.35%) presented with acute croup syndrome. The prevalence of hyponatremia in lower respiratory tract infection was found to be 42.3%. Out of 36 cases of hyponatremia associated with lower respiratory tract infection, 25 (69.4%) had mild hyponatremia, 8 (22.2%) had moderate hyponatremia and 3 (8.3%) had severe hyponatremia. In our study, out of 36 cases of hyponatremia, 33 (91.66%) were present in pneumonia group and only 3 (8.33%) presented in nonpneumonia group. p value was 0.00 and z value is 3.817. The results were statistically significant. Hyponatremia was found in all cases of very severe pneumonia i.e. 13 (100%) as compared to 16 (53.33%) in severe pneumonia group and only 3 (18.75%) in pneumonia group, but there was no significant association between severity of hyponatremia and pneumonia grading as the p value was 0.145 (<0.05). CONCLUSIONS The prevalence of hyponatremia in paediatric patients with lower respiratory tract infection was found to be 42.3%. Hyponatremia was more common in pneumonia group (91.66%) as compared to the non-pneumonia group (8.33%). Severe hyponatremia was seen more commonly with increase in severity of pneumonia; so diagnosing hyponatremia in early stage and correcting by appropriate interventions plays an important role in outcome of children suffering from pneumonia.

Assessment of serum sodium levels in patients of lower respiratory tract infections (LRTI) in children at tertiary care center

“…The study population contained 37 (56.9 percent) males and 28 (43.1 percent) females in the present study. The similar data was obtained in the study done by Attri et al [14] where there were 70% male children and 30% female children and Mhatre et al [15] notes that males with hyponatremia were twice as often affected in acute lower respiratory tract infections as females.The prevalence of hyponatremia in the present study was 33.8%. Out of 33.8% hyponatremia cases, mild hyponatremia found to be [7].…”

The frequency of hypernatremia at presenting to the Emergency Department with acute bronchiolitis

“…Although these symptoms are common in acute bronchiolitis, there is a large literature on hyponatremia accompanying lower respiratory tract infections. It is generally accepted that this is caused by the release of non-osmotic antidiuretic hormone (ADH) in acute bronchiolitis patients [5][6][7][8].…”