Akdeniz Osman, Çelik Muhittin, Samancı Serhat
Department of Pediatrics, Diyarbakir Children's Hospital, Diyarbakir, Turkey.
Turk Arch Pediatr. 2021 Jul 1;56(4):344-349. doi: 10.5152/TurkArchPediatr.2021.20153. eCollection 2021 Jul.
We aimed to evaluate the demographic, clinical, and laboratory findings and the management of newborns with hypernatremic dehydration (HDH).
A total of 85 term newborns with serum sodium (Na) levels higher than 145 mEq/L who admitted to our hospital between January 2011 and December 2018 were included in this study.
Among all cases, 54.1% were female infants with the mean birth weight, weight loss ratio, and median age at diagnosis of 3095 ± 540 g, 13.6 ± 10%, and 8 (2-24) days, respectively. The most common presenting complaints were breastfeeding difficulties (90.5%), fever (63.5%), decreased urination (43.5%), jaundice (22.3%), and convulsion (15.3%). The mean sodium and potassium, and median blood urea and creatinine levels on admission were 167.9 ± 13.4 mEq/L, 5.4 ± 2.8 mmol/L, 213 mg/dL (11-476 mg/dL), and 2.4 mg/dL (0.52-9.96 mg/dL), respectively. There was metabolic acidosis in 67% and acute renal failure in 74.4% of patients, while peritoneal dialysis was performed in 12 of them. There was a positive correlation between weight loss ratio and admission age, serum urea, and creatinine levels; there was a negative correlation between weight loss and blood pH. Eight patients died (9.4%).
In our study, serum urea, creatinine, potassium, metabolic acidosis levels, convulsion, and dialysis requirements at the time of admission of the newborns with HDH were found to be higher in those who died compared to those who survived. Convulsion was a presenting complaint, and it was also observed during the treatment.
我们旨在评估高钠血症性脱水(HDH)新生儿的人口统计学、临床和实验室检查结果以及治疗情况。
本研究纳入了2011年1月至2018年12月期间入住我院的85例足月新生儿,其血清钠(Na)水平高于145 mEq/L。
在所有病例中,54.1%为女婴,诊断时的平均出生体重、体重减轻率和中位年龄分别为3095±540 g、13.6±10%和8(2 - 24)天。最常见的主诉是母乳喂养困难(90.5%)、发热(63.5%)、尿量减少(43.5%)、黄疸(22.3%)和惊厥(15.3%)。入院时的平均钠和钾水平以及中位血尿素和肌酐水平分别为167.9±13.4 mEq/L、5.4±2.8 mmol/L、213 mg/dL(11 - 476 mg/dL)和2.4 mg/dL(0.52 - 9.96 mg/dL)。67%的患者存在代谢性酸中毒,74.4%的患者存在急性肾衰竭,其中12例患者进行了腹膜透析。体重减轻率与入院年龄、血清尿素和肌酐水平呈正相关;体重减轻与血液pH值呈负相关。8例患者死亡(9.4%)。
在我们的研究中,发现与存活的HDH新生儿相比,死亡新生儿入院时的血清尿素、肌酐、钾、代谢性酸中毒水平、惊厥和透析需求更高。惊厥是一种主诉,在治疗过程中也有观察到。