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Severe dehydration and acute renal failure associated with external ventricular drainage of cerebrospinal fluid in

S Simpson1, M Yung, A Slater

  • 1Paediatric Intensive Care Unit, Women's and Children's Hospital, Adelaide, South Australia.

Anaesthesia and Intensive Care
|October 26, 2006
PubMed

Insights

Severe dehydration and hyponatremia with circulatory compromise occurred in children with external ventricular drains. Increased vigilance is needed to manage these critical fluid balance complications in pediatric patients.

Area of Science:

  • Pediatric critical care medicine
  • Neurocritical care
  • Pediatric neurosurgery

Background:

  • External ventricular drainage (EVD) is a common neurosurgical procedure to manage intracranial pressure.
  • Maintaining fluid and electrolyte balance is crucial in pediatric patients undergoing EVD.

Observation:

  • Three pediatric cases presented with severe dehydration and hyponatremia.
  • These complications were associated with the use of external ventricular drainage.
  • Two patients experienced cardiac arrest but were successfully resuscitated.

Findings:

  • External ventricular drainage can lead to significant fluid loss and electrolyte disturbances.
  • Hyponatremia and dehydration can precipitate life-threatening circulatory compromise in children.
  • Incomplete fluid balance data may obscure the direct relationship but does not negate the observed association.

Implications:

  • Clinicians must maintain heightened vigilance for fluid and electrolyte imbalances in pediatric patients with EVD.
  • Proactive monitoring and management strategies are essential to prevent severe complications.
  • Further research into optimal fluid management protocols for pediatric EVD is warranted.

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