Hyponatremia and Its Effects on Prognosis in A Tertiary Pediatric Intensive Care Unit

Abstract

Introduction: Hyponatremia is accepted as an independent risk factor in pediatric intensive care units. Many comorbidities such as infectious diseases, central nervous system problems and incorrect replacement solutions are blamed in the pathogenesis of hyponatremia. In this study, we aimed to investigate the etiology and prognosis of hyponatremia in a tertiary pediatric intensive care unit. Materials and Methods: We retrospectively analyzed 342 pediatric patients hospitalized in the pediatric intensive care unit of Kayseri City Hospital. Patients with a serum sodium level below 135 mEq/L were considered hyponatremia. Critical hyponatremia was defined as serum sodium less than 125 mEq/L. Data on length of hospital stay, mortality and comorbidities were analyzed. Results: The data of 342 pediatric patients were evaluated. The male/female ratio was 192/150 (56.1% vs. 43.9%). The mean age of the patients was 41.78 months (±57.7) (min-max 1-212). Twenty-five patients had serum sodium below 125 mEq/L, which could be defined as critical hyponatremia. The mean sodium was 131 (±3.3) mEq/L (min-max: 109-134). The levels of serum creatinine significantly differs before and after treatment (p<0.001). The mean resolution time of hyponatremia was 2.1 days (±1.29) (min-max: 1-12) Serum sodium was 125 mEq/L and below in a total of 23 patients. The mortality rate was 23% in all patients at the end of their follow-up. Conclusions: Hyponatremia is a common problem in pediatric intensive care unit. Especially severe hyponatremia can be related with increased mortality. Close monitoring of sodium is needed in especially trauma patients and central pathologies as well as bronchopneumonia patients.