Incidence of postoperative hyponatremia and complications in critically-ill children treated with hypotonic and normotonic solutions.
OBJECTIVE
To determine the incidence and clinical consequences of postoperative hyponatremia in children.


METHODS
We performed a retrospective analysis of postoperative admissions to the pediatric intensive care unit (excluding cardiac, neurosurgical, and renal). The incidence of severe (serum sodium < 125 mmol/L or symptoms) and moderate (serum sodium < 130 mmol/L) hyponatremia in children receiving hypotonic (HT) and normotonic (NT) fluids was calculated.


RESULTS
Out of a total of 145 children (568 sodium measurements; 116 HT and 29 NT), we identified 16 with hyponatremia (11%). The incidences of moderate (10.3% vs 3.4%, P = .258) and severe (2.6% vs 0%; P = .881) hyponatremia were not significantly different in the HT and NT groups. There were no neurologic sequelae or deaths related to hyponatremia.


CONCLUSIONS
In our study group, hyponatremia was common, but morbidity and death were not observed. Careful monitoring of serum sodium level may be responsible for this lack of adverse outcomes. Larger, prospective studies are needed to determine whether the incidence of hyponatremia differs between the HT and NT groups.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000453:epidemiology* / Q000209:etiology*; D007038:Hypotonic Solutions / Q000008:administration & dosage* / Q000009:adverse effects*; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D007552:Isotonic Solutions / Q000008:administration & dosage*; D008297:Male; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood*
D007038:Hypotonic Solutions; D007552:Isotonic Solutions; D012964:Sodium