Admission Dysnatremia in Citically ill Children

Many causes of admission to the pediatric intensive care unit (PICU) may potentially induce hyponatremia. This study was aimed at evaluating the incidence of admission dysnatremia in the PICU and its relationship with the underlying disease and demographic factors.
This observational prospective study was conducted in a 12-bed medical PICU in a tertiary governmental teaching hospital for six months. The study group comprised patients aged 1 month to 18 years. Patients who received intravenous fluid within 24 hours before admission were excluded. Serum sodium was checked on admission and concentrations below 135 and above 145 mEq/L were considered hyponatremia and hypernatremia, respectively.
One hundred and ninety-five patients (117 males, 60%) were included in the study. The mean serum sodium level was 137.8 mEq/L ± 5.2. Forty-two patients (20.5%) were hyponatremic and 10 (5.1%) were
hypernatremic. The most prevalent diagnosis in hyponatremic patients
was pulmonary diseases followed by renal diseases, central nervous
system (CNS) diseases, diabetic ketoacidosis (DKA), gastrointestinal (GI)
diseases, and cardiovascular and hematologic-oncologic diseases. Fifty
percent of nephrologic patients were hyponatremic. Hyponatremia was
found in 26.5%, 23.5%, 20%, 16.6%, and 14.2%of the children with lung
diseases, DKA, hematologic-oncologic diseases, cardiovascular diseases,
and CNS and GI diseases, respectively. Moreover, 20%, 16.6%, 11.7%,
7.1%, and 2.9%of the patients with infectious diseases, cardiovascular
diseases, DKA, CNS diseases, and pulmonary diseases had
hypernatremia, respectively.
Hyponatremia is frequent in our PICU. Patients suffering from renal diseases, pulmonary problems, DKA, and hematologic-oncologic diseases have a higher chance of hyponatremia (≥20%).