title: Acquired hyponatremia in pediatric living donor liver transplantation.
abstract: BACKGROUND
  The aim of this study was to evaluate the incidence of acquired hyponatremia (AH) in our pediatric living donor liver transplantation (LDLT) patients, and to identify the potential predictive risk factors of the causes of AH.
  
  
  METHODS
  The 189 pediatric LDLT patients were divided into 2 groups: serum sodium level at the end of the surgery lower than 130 mEq/L in GI (n=16) and higher than 130 mEq/L in GII (n=173). Patients' data were analyzed by Mann-Whitney U test, univariate analysis, and multiple binary logistic regression model. The Hosmer-Lemeshow goodness-of-fit test was used to evaluate the logistic model formulated. P value <0.05 was regarded as statistically significant.
  
  
  RESULTS
  In the multiple binary logistic regression model, the hypotonic solution administration rate (ml/kg/h) was the only independent predictor of AH with a p<0.017. Receiver operating curve (ROC) analysis indicated that giving more than 3.5 ml/kg/h hypotonic solution infusion may cause AH. Preoperative hyponatremia did not increase the incidence of acquired hyponatremia.
  
  
  CONCLUSIONS
  Increasing the administration of hypotonic solution by 1 ml/kg/h in pediatric LDLT would increase the risk of developing AH by 1.272 times. The critical administration rate of hypotonic solution was 3.5 ml/kg/h.
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Sheng-Chun
authors.initials: SC
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chih-Hsien
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Department of Surgery and Liver Transplant Program, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chao-Long
authors.initials: CL
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Kwok-Wai
authors.initials: KW
authors.lastname: Cheng
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Shao-Chun
authors.initials: SC
authors.lastname: Wu
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Tsung-Hsiao
authors.initials: TH
authors.lastname: Shih
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Bruno
authors.initials: B
authors.lastname: Jawan
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chia-Jung
authors.initials: CJ
authors.lastname: Huang
mesh_terms: D002648:Child; D002675:Child, Preschool; D005440:Fluid Therapy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007010:Hyponatremia / Q000209:etiology*; D007038:Hypotonic Solutions; D007223:Infant; D016031:Liver Transplantation; D019520:Living Donors; D016015:Logistic Models; D017063:Outcome Assessment, Health Care; D011182:Postoperative Care / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D007038:Hypotonic Solutions