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pediatric hypernatremia

Pilar Velasco, Andrés J Alcaraz, Niki Oikonomopoulou, Marina Benito, Raquel Moya, Álvaro Sánchez
INTRODUCTION: The objective of this study was to evaluate the association between the type of initial fluid therapy used (isotonic or hypotonic solutions) and the development of hyponatremia, the plas ma chlorine values and the tolerance of venous access. PATIENTS AND METHOD: Retrospective cohort study in a Pediatric Intensive Care Unit (PICU) of a high complexity hospital. There were included children younger than 15 years old hospitalized during the first semester of 2010 and 2013 who recei ved intravenous maintenance fluid therapy, excluding patients undergoing cardiac surgery, kidney transplant and admissions that lasted less than 24 hours...
February 2018: Revista Chilena de Pediatría
Krisha Le Palma, Elisha Rampolla Pavlick, Lawrence Copelovitch
Background: Current treatment options for chronic hyperkalemia in children with chronic kidney disease include dietary restrictions or enteral sodium polystyrene sulfonate (SPS); however, dietary restrictions may compromise adequate nutrition and enteral SPS may be limited by palatability, adverse effects and feeding tube obstruction. A potentially safer alternative is to pretreat enteral nutrition (EN) with SPS prior to consumption. The purpose of this study was to evaluate the efficacy and safety of pretreating EN with SPS in pediatric patients with hyperkalemia...
April 2018: Clinical Kidney Journal
Rui Zhang, Zhi-Jun Zhu, Li-Ying Sun, Lin Wei, Wei Qu
Background: The outcome of pediatric deceased donor liver transplantation (LT) has not been well studied, especially pediatric deceased donor livers used in adult transplantation. This study aimed to evaluate the efficacy of LT using pediatric deceased donor livers and compare the outcomes between pediatric-to-pediatric LT and pediatric-to-adult LT. Methods: A retrospective review of LT using pediatric deceased donor livers from June 2013 to August 2016 was performed...
March 20, 2018: Chinese Medical Journal
Eike Blohm, Amy Goldberg, Ann Salerno, Carole Jenny, Edward Boyer, Kavita Babu
OBJECTIVES: Immediate recognition of salt toxicity and aggressive resuscitative measures are critical in the treatment of this lethal poisoning. Despite heroic measures, pediatric deaths due to salt toxicity still occur from irreversible neurological damage. The objective of this article is to review the relevant literature and offer a therapeutic algorithm for the management of pediatric patients presenting with salt toxicity. METHODS: A literature search for cases of salt toxicity was conducted...
October 31, 2017: Pediatric Emergency Care
Jennifer Fuchs, Sarah T Adams, Julie Byerley
BACKGROUND: Fluid and electrolyte therapy is an important component in the care of the hospitalized child. Previous pediatric guidelines have followed the Holliday-Segar method of calculating and delivering maintenance IV fluids, using hypotonic fluids in maintenance therapy. However, research demonstrates that hypotonic fluids can lead to iatrogenic hyponatremia and that isotonic fluid is a safer alternative. OBJECTIVE: To provide the ideal approach to intravenous (IV) fluid use in the hospitalized child and determine the safety and effectiveness of isotonic maintenance fluid therapy...
2017: Reviews on Recent Clinical Trials
Alma Beatriz Medrano-Rodríguez, Rosa Ortega-Cortés, Elvira Torres-Infante, Alejandro Macario-Reynoso, Juan Carlos Barrera-de León
BACKGROUND: The importance of hyponatremia is underestimated despite it is a frequent alteration in a hospital environment. Usually no cause is investigated and it is treated as an isolated data. The aim was to determine the prevalence and etiology of hyponatremia in pediatric patients. METHODS: Cross-sectional study of 72 patients from 1-month to 15-years of age admitted to the emergency room, from May to September, 2015, with lower serum determination of Na < 135 mEq/L at admission...
2017: Revista Médica del Instituto Mexicano del Seguro Social
Cornelia Späth, Elisabeth Stoltz Sjöström, Fredrik Ahlsson, Johan Ågren, Magnus Domellöf
BACKGROUND: Hyper- and hyponatremia occur frequently in extremely preterm infants. Our purpose was to investigate plasma sodium (P-Na) concentrations, the incidence of hyper- and hyponatremia, and the impact of possible predisposing factors in extremely preterm infants. METHODS: In this observational study, we analyzed data from the EXtremely PREterm (< 27 wk.) infants in Sweden Study (EXPRESS, n = 707). Detailed nutritional, laboratory, and weight data were collected retrospectively from patient records...
March 2017: Pediatric Research
L F Ye, Y Fan, C M Zhang, Q Shu, L Z Du, R Lin
Objective: To summarize clinical experience of using extracorporeal membrane oxygenation (ECMO) in rescuing children with acute fulminant myocarditis (AFM). Method: Data of 12 children with acute fulminate myocarditis (6 boys and 6 girls, median age 8.3 (0.6, 13.0) years, median weight 33.1 (6, 61) kg) who were rescued with ECMO in Children's Hospital, Zhejiang University from September 2009 to August 2015 were analyzed retrospectively. The analysis focused on the intervene timing of ECMO for the cardiogenic shock and hypoperfusion caused by heart failure and(or) lethal arrhythmia and the essentials of ECMO cardiopulmonary resuscitation(ECPR) for cardiac arrest in pediatric AFM were summarized...
November 2, 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Shikha Shukla, Srikanta Basu, Michael L Moritz
AIM: To evaluate maintenance intravenous fluid-prescribing practices and the incidence of hospital-acquired hyponatremia in children admitted to a general pediatric ward. METHODS: This is a prospective observational study conducted over a 2-month period in children ages 2 months to 5 years who were admitted to a general pediatric ward and who were receiving maintenance intravenous fluids. The composition, rate, and duration of intravenous fluids were chosen at the discretion of the treating physician...
2016: Frontiers in Pediatrics
Fredrick Ibinda, Hans-Christoph Zarnack, Charles R Newton
BACKGROUND: Perturbations of blood sodium are the most frequently encountered electrolyte disorder in sick children, and may influence fluid therapy. We examined the frequency of blood sodium perturbations, and factors and outcomes associated with hyponatremia in children admitted to a rural Kenyan hospital and investigated the risk factors associated with deaths in hyponatremic children. METHODS: Plasma sodium levels and other laboratory parameters were measured in children admitted to a rural Kenyan hospital...
2016: PloS One
Musa Silahli, Mahmut Gökdemir, Enes Duman, Zeynel Gökmen
We present a catheter related severe hypernatremia in a 2-month-old baby who was admitted to the pediatric intensive care. Imbalance of plasma sodium is commonly seen in pediatric intensive care patients. The water and sodium balance is a complex process. Especially, brain and kidneys are the most important organs that affect the water and sodium balance. Other mechanisms of the cellular structure include osmoreceptors, Na-K ATPase systems, and vasopressin. Hypernatremia is usually an iatrogenic condition in hospitalized patients due to mismanagement of water electrolyte imbalance...
September 2016: Journal of Clinical Anesthesia
Kioomars Golshekan, Hamidreza Badeli, Mahboube Miri, Maryam Mirzaie, Afagh Hassanzadeh Rad, Fatemeh Salamat, Sepideh Abdi Tazeabadi, Nahid Bidar, Kobra Blouki-Moghaddam, Houman Hashemian
INTRODUCTION: Gastroenteritis (GE) is one of the most common pediatric diseases. Hyponatremia commonly occurs by administering hypotonic fluids to GE and hospitalized children. Yet, there is no consensus on the ideal method of treatment. OBJECTIVES: we aimed to assess suitable intravenous (IV) fluid for preventing dysnatremia in children with GE. PATIENTS AND METHODS: This is a double blind randomized clinical trial, which was conducted on infants of 6 months up to 14 years children with GE...
2016: Journal of Renal Injury Prevention
Ryoji Aoki, Tetsuji Morimoto, Yuno Takahashi, Hiroshi Saito, Tatsuo Fuchigami, Shori Takahashi
Extrapontine myelinolysis (EPM) is an uncommon disorder in children, with few pediatric cases reported to date. We report the first case of an infant with EPM without central pontine myelinolysis (CPM) presenting with severe hypernatremia. On admission, the infant had impaired consciousness, mild dehydration, and severe hypernatremia (190 mmol/L). The following day, the patient developed abnormal involuntary movements. Brain magnetic resonance imaging (MRI) confirmed EPM without CPM. He recovered without sequelae, and clinical examinations were within normal limits approximately 6 months after discharge...
September 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Sarah Depallens, Nicolas Lutz, Raffaella Carlomagno, Blaise Meyrat, Mirjam Schuler Barazzoni, Yves Yamgoue Tchameni, Andres Pascual, François Scerba, Andrea Superti-Furga
Every pediatrician will be confronted with newborns oryoung infants with skin lesions in proximity of the vertebral column. It is important not to miss a spinal dysraphism because of the risk of meningeal infection or of the possible presence of a tethered cord. A practical algorithm is presented. Non-accidental injury in young infants and toddlers is not rare but difficult to detect. Bruises and fractures are highly suspicious for non-accidental injury and should trigger specific investigations. Emergency departments and hospitals are switching from hypotonic to isotonic solutions as maintenance infusions of children...
January 13, 2016: Revue Médicale Suisse
Phillip S Adams, Antonio Cassara
Polyuria related to pharmacologic α2-adrenoreceptor agonism has been well described in vitro and in animal models and is thought to be the result of functional antagonism of arginine vasopressin. Despite its widespread use as a sedative and anesthetic adjunct, very few reports of dexmedetomidine-related polyuria in humans exist in the literature. We present the first description of a pediatric patient manifesting polyuria and hypernatremia in association with dexmedetomidine infusion for posterior spinal fusion...
April 2016: Journal of Anesthesia
Jeong Jin Lee, Young-Soon Kim, Hae Hyuk Jung
The objective of this study is to investigate the degree of serum sodium changes and its association with patient outcomes in pediatrics undergoing heart surgery with cardiopulmonary bypass (CPB). We reviewed the medical records of 275 pediatric patients who underwent heart surgery with CPB. Prior to CPB, hyponatremia (≤135 mmol/L) was observed in 21 of 275 patients. After initiation of CPB, serum sodium decreased significantly and severe hyponatermia (≤130 mmol/L) subsequently developed in 32 patients...
2015: SpringerPlus
Sarah C Jernigan, Scellig S D Stone, Joshua P Aronson, Melissa Putman, Mark R Proctor
Patients with shunted hydrocephalus presenting with altered mental status and ventriculomegaly are generally considered to be in shunt failure requiring surgical treatment. The authors describe a case of shunted hydrocephalus secondary to a disseminated neuroectodermal tumor in a pediatric patient in whom rapid fluctuations in sodium levels due to diabetes insipidus repeatedly led to significant changes in ventricle size, with invasively confirmed normal shunt function and low intracranial pressure. This clinical picture exactly mimics shunt malfunction, requires urgent nonsurgical therapy, and underscores the importance of considering serum osmolar abnormalities in the differential diagnosis for ventriculomegaly...
October 2015: Journal of Neurosurgery. Pediatrics
Yun Cui, Yucai Zhang, Qunfang Rong, Liang Xu, Yan Zhu, Yuqian Ren
OBJECTIVE: High-volume hemofiltration (HVHF) is an potential therapy for the treatment of sverve sepsis in intensive care unit, but little information is avialible in children. The aim of our study was to evaluate the effects of HVHF compared with standard-volume continuous veno-venous hemofiltration (CVVH) for critically ill children with severe sepsis, and to evaluate the feasibility and tolerance. METHODS: A single-center prospective trial was performed on the data of critically ill children with sverve sepsis, who were treated with 48hours HVHF (effluent rate 50 - 70 ml ...
February 3, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Maria Clara da Silva Valadão, Jefferson Pedro Piva, João Carlos Batista Santana, Pedro Celiny Ramos Garcia
OBJECTIVE: To compare two electrolyte maintenance solutions in the postoperative period in children undergoing appendectomy, in relation to the occurrence of hyponatremia and water retention. METHODS: A randomized clinical study involving 50 pediatric patients undergoing appendectomy, who were randomized to receive 2,000mL/m(2)/day of isotonic (Na 150 mEq/L or 0.9% NaCl) or hypotonic (Na 30 mEq/L NaCl or 0.18%) solution. Electrolytes, glucose, urea, and creatinine were measured at baseline, 24h, and 48h after surgery...
September 2015: Jornal de Pediatria
Neema Kaseje, Valerie McLin, Christian Toso, Antoine Poncet, Barbara E Wildhaber
The demand for transplantable organs far outweighs the supply. Recently, efforts have been made to increase the donor pool by adopting extended criteria for livers, including those from hypernatremic donors. Currently, there is no clear evidence that the use of organs from hypernatremic donors has detrimental effects on pediatric liver transplantation (LT) recipients. Our aim was to use the Scientific Registry of Transplant Recipients database to evaluate the effects of donor hypernatremia on 30-day outcomes in pediatric LT recipients...
August 2015: Liver Transplantation
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