Hyponatremia in Children Hospitalised with Community-acquired Pneumonia: A Prospective Observational Study SC01-SC04
Dr. Mohd Haseeb,
Plot No. 98, N13, Cidco Himayat Baugh, Aurangabad, Maharashtra, India.
Introduction: Community-acquired Pneumonia (CAP) is a common cause of mortality and morbidity among the under-5 years age population. Hyponatremia (HN) is common in patients with CAP, it is usually asymptomatic but it is associated with severe disease and poor outcome. Its monitoring and early identification can guide proper fluid therapy in patients with CAP.
Aim: To evaluate the occurrence of Hyponatremia (HN) in paediatric patients with CAP and to analyse its association with severity of pneumonia.
Materials and Methods: This prospective observational study was conducted in MGM Medical College and Hospital Aurangabad, India, over a period of 2 years. Serum sodium concentration was measured in 76 hospitalised children with clinically and radiologically confirmed CAP. Those with hyponatremia were identified. Statistical analysis was done by chi-square test for categorical variables and t-test for continuous variables to study the relationship of hyponatremia with various clinical parameters and inflammatory markers.
Results: Out of 76 patients, 41(54%) had hyponatremia on the day of admission. In the majority of patients (38.2%), HN was mild (mild HN 131-134 mEq/L moderate HN 126-130 mEq/L, severe HN less than 125 mEq/L). None of the patients had neurological symptoms due to HN. On admission, hyponatremic patients had higher white blood cell count (40 vs. 28 p 0.013), neutrophil count (38 vs. 25 p 0.014) and serum C-reactive protein (39 vs. 28 p 0.032) than normonatremic ones. No association was found with the type of intravenous fluid (0.45% DNS or Isolyte P) used and hyponatremia (P 0.6471).
Conclusion: It can be concluded that hyponatremia is common in CAP and it is associated with the disease severity.