Al-Lamki Zakia, Farooqui Mahfooz A, Ahmed Saeed
Department of Child Health, Sultan Qaboos University, College of Medicine and Health Sciences, P.O.Box 35, Al-Khod, Muscat 123, Sultanate of Oman.
Sultan Qaboos Univ Med J. 2006 Jun;6(1):13-6.
Our two main objectives are to assess the incidence and the outcome of severe hyponatremia in young hospitalized patients.
We retrospectively reviewed the incidence and outcome of severe hyponatremiac (Na <125 mmol/l) inpatients less than 18 years of age, admitted as consecutive admissions during one calender year. Psuedohyponatremia and artifactual hyponatremia were excluded. Patients' demographics, clinical features, laboratory, treatment and outcomes were recorded.
Of 3561 admissions of patients less than 18 years of age, 20 developed severe hyponatremia. Nausea, vomiting, irritability, clouded sensorium and seizures were the most common symptoms and signs. Underlying central nervous system disease, pneumonia and malignancy were major co-morbid conditions. The initial volume status was determined as hypervolemia (n=7), hypovolemia (n=7) and euvolemia (n=6). Iatrogenic (diuretics 5 and hypotonic fluids 7) hyponatremia accounted for 60% of all cases. Mortality was 20%.
Patients receiving intravenous hypotonic fluids should be closely monitored for the development of hyponatremia. The common etiology of hyponatremia in our studied cohort of patients is iatrogenic.
我们的两个主要目标是评估年轻住院患者中严重低钠血症的发生率和转归。
我们回顾性分析了18岁以下严重低钠血症（血钠<125 mmol/l）住院患者的发生率和转归，这些患者为一个日历年内连续收治。排除假性低钠血症和人为性低钠血症。记录患者的人口统计学资料、临床特征、实验室检查、治疗及转归。
在3561例18岁以下患者的入院病例中，20例发生严重低钠血症。恶心、呕吐、烦躁、意识模糊和癫痫发作是最常见的症状和体征。潜在的中枢神经系统疾病、肺炎和恶性肿瘤是主要的合并症。初始容量状态确定为高血容量（n = 7）、低血容量（n = 7）和等血容量（n = 6）。医源性（利尿剂5例和低渗液7例）低钠血症占所有病例的60%。死亡率为20%。
接受静脉输注低渗液的患者应密切监测低钠血症的发生。在我们研究的患者队列中，低钠血症的常见病因是医源性的。
