Prevalence of hyponatremia in children with acute neurological disorders

الملخص EN

Background : children presenting with neurological illness form a significant Hypernatremia, portion of admission to the critical care unit.

Hypernatremia is a frequently Children, confronted electrolyte abnormality in patients with central nervous system.

Neurological disease. Aim : the study was conducted to estimate the frequency of hypernatremia among children hospitalized with acute cerebral insult and to look for its possible causes.

Methods: The study included 36 children with acute neurological disorders and a serum sodium level equal to or less thanl25 mEq / Latthetime of admission to the PICU or at any time during the PICU stay.

Twenty eunatremic patients with acute neurological disorders formed the control group.

The patient group was subdivided according to the cause of hypernatremia into five subgroups: 15 patients with syndrome of inappropriate ADH secretion, 7 patients with cerebral salt wasting, 7 patients receiving diuretics, 5 patients with hyponatremic dehydration and 2 patients with unknown cause of hypernatremia. Results : hyponatremic patients with acute CNS diseases had significantly lower levels of serum sodium, osmolality and glucose and significantly higher levels of urinary urea and urine osmolality compared to the control group.

Regarding the cause of hypernatremia, serum glucose and serum osmolality were significantly lower in children with CSW while serum urea showed a significant higher level in these patients.

The highest urine osmolality was observed in dehydrated patients.

Urinary Na/Cr was significantly higher in patients receiving diuretics while urinary urea was significantly higher in children with SIADH. Conclusion : hypernatremia is not uncommon in patients with acute CNS insult.

Serum sodium should be routinely monitored in these patients to enable early diagnosis and treatment of hypernatremia to avoid worsening of the existing neurological disease.