Oral Rehydration in Hypernatremic and Hyponatremic Diarrheal Dehydration

Pizarro, D; Posada, Gloria; Villavicencio, Nora; Mohs, Edgar; Levine, Myron M.

doi:10.1001/archpedi.1983.02140340014003

Cited by 65 publications

(21 citation statements)

References 27 publications

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“…Gastroenteritis contributed to hypernatraemia in 11.7% of all patients. Therefore, the incidence of hypernatraemia caused by acute gastroenteritis in infants was much lower than that in previous studies (18). Apart from acute gastroenteritis, 47% of children with hypernatraemia on admission had diarrhoea and vomiting; this increased to 59% in children with hospital- acquired hypernatraemia (Table 1).…”

Section: Discussionmentioning

confidence: 72%

“…Neonatal hypernatraemic dehydration may be caused by inadequate nutrition and artificial feeds that lead to an elevated level of sodium (11,14). It has been reported previously that hypernatraemia in infants is caused by gastroenteritis (15)(16)(17)(18). Recently, hypernatraemia has been primarily a hospital-acquired disease, caused by failure to administer sufficient free water to patients unable to care for themselves (19).…”

Section: Discussionmentioning

confidence: 99%

“…The rate of correction of hypernatraemia is dependent on the severity and cause of hypernatraemia. When hypernatraemia is corrected rapidly, it can lead to cerebral oedema (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). In severe hypernatraemia (>170 mEq/L), serum sodium level should not be decreased to <150 mEq/L in the first 48-72 h. Seizures during the correction of hypernatraemia are not uncommon in children and might be a sign of cerebral oedema.…”

Section: Discussionmentioning

confidence: 99%

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Hypernatremia in hospitalized children

et al. 2017

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Objective: Hypernatraemia has serious complications such as brain injury, brain oedema and seizure. In this study, the incidence among children hospitalized hypernatremia, causes, development time, clinical features, and morbidity, and aimed to reveal the effect on mortality. Method: In this retrospective study, clinical and laboratory data from patients with hypernatremic were recorded. The study period was 33 months. The groups were separated into two groups; group I: Hypernatremia was present at hospital admission, group II: Hypernatremia was acquared after the hospitalization. Results: Overall incidence of hypernatraemia was 1.3% of all hospitalised children. While 42% of patients were from group I, 58% of patients had acquired hypernatremia during hospital stay. In group I, 61% of patients had infections on hospital admission. The most common cause of hypernatraemia in group II was neurological disorders (53%). The mortality rate was 30.5% (11/36) in patients with hypernatraemia on admission, 67.3% (33/49) in those with hospital-acquired hypernatraemia (P<0.05; significantly greater than for those with hypernatraemia on admission), and 51.7% (44/85) overall. Mean serum sodium level was higher in non-survivors than in survivors (161.7±8.3 mg/dL vs. 160±7.4 mg/dL), but the difference was not statistically significant. Similarly, there was no significant difference in peak serum sodium levels in survivors versus non-survivors, P>0.05. Conclusion: Hypernatraemia in pediatric age is associated with mortality and morbidity, and should be closely monitored in pediatric patients hospitalized for any reason in order to prevent complication.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hypernatremia in hospitalized children

et al. 2017

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“…Although oral rehydration is often considered for children with modest dehydration and no presumed electrolyte anomalies, oral rehydration with WHO or WHO-like solution has also been used in cases of dehydration accompanied by hyponatremia or hypernatremia [114,115]. Although most children with severe hypernatremia (>160 mEq/L) can be successfully rehydrated orally, there have been reports of seizures, generally as a result of too rapid correction of serum sodium from the provision of supplemental water along with the glucose-electrolyte solution [114,115].…”

Section: Oral Rehydration and Serum Sodium Abnormalitiesmentioning

confidence: 99%

“…Although most children with severe hypernatremia (>160 mEq/L) can be successfully rehydrated orally, there have been reports of seizures, generally as a result of too rapid correction of serum sodium from the provision of supplemental water along with the glucose-electrolyte solution [114,115]. In those cases, the average serum sodium fell by 10-15 mEq/L over 6 h rather than over 24 h as advised.…”

Section: Oral Rehydration and Serum Sodium Abnormalitiesmentioning

confidence: 99%