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Neurological symptoms in hospitalised patients: do we assess hyponatraemia with sufficient care?
Author(s) -
Rodríguez M Jose,
Alcaraz Andrés,
Solana Maria Jose,
García Ana
Publication year - 2014
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12439
Subject(s) - medicine , intensive care medicine , hyponatremia , pediatrics , medline , political science , law
Aim To review the incidence of hyponatraemic encephalopathy in children treated in a tertiary care centre hospital, together with the clinical setting and clinical management of these cases. Methods Retrospective descriptive study by chart review of patients admitted to hospital during 2000–2010. Patients older than 1 month were included who had severe hyponatraemia (sodium concentration <125 mmol/ L ) on admission or during their hospital stay and co‐incidental neurological symptoms. Epidemiological, clinical, laboratory and therapeutic data were collected. Results We analysed 41 cases of severe hypotonic hyponatraemia and neurological symptoms compatible with hyponatraemic encephalopathy. Boys accounted for 56.1% patients, and the median age was 1 year. Hyponatraemia was acquired in hospital by 61% of the patients, and 88% of those patients were receiving intravenous hypotonic fluids. The most frequent neurological symptom was seizures. The most common therapeutic strategy was sodium supplementation and antiepileptic drugs. Hypertonic fluids were only used in the initial treatment of 16 patients. There were two deaths related to hyponatraemic encephalopathy. Conclusion Hyponatraemia should always be considered a cause of neurological symptoms in hospitalised patients. Treatment should be prompt to prevent neurological sequelae and death. Current recommendations for fluid management in hospitalised children should be reviewed.