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Hypernatraemia in early infancy
1Department of Paediatrics, Faculty of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates. iradj.amirlak@uaeu.ac.ae
Insights
Severe hypernatraemia (serum sodium > 150 mmol/l) remains common in tropical regions. This study details two infant cases, highlighting causes like poor fluid intake and high solute intake, and reviews management strategies.
Area of Science:
- Pediatrics
- Internal Medicine
- Environmental Health
Background:
- Hypernatraemia, characterized by serum sodium levels exceeding 150 mmol/l, is a frequent clinical challenge, particularly in tropical environments.
- Infants are especially vulnerable due to their higher body water content and immature regulatory mechanisms.
Observation:
- Two infant cases of severe hypernatraemia are presented.
- Case 1 involved poor fluid intake and excessive wrapping, leading to dehydration.
- Case 2 was associated with a high solute intake, overwhelming the infant's water balance.
Findings:
- The study outlines the pathophysiology of hypernatraemia, including sodium overload, inadequate water intake, and excessive water losses (renal and non-renal).
- Essential hypernatraemia is also discussed as a potential cause.
- Literature review supports these multifactorial causes in pediatric populations.
Implications:
- Understanding these diverse causes is crucial for timely diagnosis and effective management of hypernatraemia in infants.
- Clinical awareness and prompt intervention can prevent severe complications associated with electrolyte imbalances.
- This review provides an updated perspective on the current evidence-based management of hypernatraemia.
Abstract:
Hypernatraemia, defined as serum sodium > 150 mmol/l, is still seen frequently in tropical environments. We describe two infants, one with poor fluid intake and excessive wrapping and the other with a high solute intake, both of whom presented in a state of severe hypernatraemia. The pathophysiology of this condition is outlined, as are the major causes, such as sodium overload, inadequate water intake, increased water loss of non-renal origin, increased water loss of renal origin and essential hypernatraemia. The literature is reviewed and the current basis for management is appraised and discussed.