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Hyponatraemia in cases of children with pneumonia
Afroditi Sakellaropoulou1, Maria Hatzistilianou, Maria Eboriadou
12 Department of Paediatrics, Medical School, Aristotle University of Thessaloniki, Greece.
Insights
Hyponatraemia, or low sodium, is common in children with community-acquired pneumonia (CAP). Increased heart rate, breathing rate, and inflammatory markers may predict hyponatraemia severity and impact hospitalization duration.
Area of Science:
- Pediatric Medicine
- Clinical Chemistry
- Infectious Diseases
Background:
- Hyponatraemia is a frequent electrolyte imbalance in clinical practice.
- It is commonly observed in children diagnosed with community-acquired pneumonia (CAP).
Purpose of the Study:
- To determine the incidence of hyponatraemia in pediatric CAP cases.
- To identify predictive tools for classifying CAP severity and outcomes.
- To explore sex-based differences in CAP and hyponatraemia.
Main Methods:
- Retrospective review of medical files for 54 children with CAP.
- Analysis of serum sodium levels at admission.
- Correlation of sodium levels with clinical signs, laboratory markers, and hospitalization duration.
Main Results:
- 33.3% of children had mild hyponatraemia, and 1.9% had moderate hyponatraemia.
- Increased heart rate and tachypnoea correlated with lower sodium levels.
- Lower sodium levels were associated with higher C-reactive protein, leukocyte count, and erythrocyte sedimentation rate.
- Hyponatraemia degree negatively correlated with hospitalization duration.
Conclusions:
- Increased heart rate, tachypnoea, leucocyte count, C-reactive protein, and erythrocyte sedimentation rate may indicate risk factors for hyponatraemia in pediatric CAP.
- These factors may influence the degree of hyponatraemia and patient outcomes.
- Further studies in larger populations are warranted.
Introduction:
Hyponatraemia is the most common electrolyte imbalance seen in clinical practice, and a common laboratory finding in children with community-acquired pneumonia (CAP). This study aimed to identify the incidence of hyponatraemia in cases of CAP, to find predictive tools in order to classify the severity and outcome of CAP and to explore possible differences of clinical importance between the two sexes.
Material And Methods:
The medical files of 54 children (66.4% males), 4.67 ±2.88 years old, were retro-prospectively reviewed.
Results:
35/54 (64.8%) children with pneumonia had normal values of sodium at admission, 18/54 (33.3%) had mild hyponatraemia and 1 child (1.9%) moderate hyponatraemia. Increased heart rhythm and tachypnoea at admission were correlated with lower values of sodium (z= -2.664, p = 0.007 and z = -1.705, p = 0.089 respectively). No differences were found between the two sexes concerning the characteristics of pneumonia or the range of sodium in serum at admission. A correlation was found between sodium admission values and: a) C-reactive protein (p = 0.000), and b) leukocyte count (p = 0.006). Sedimentation rate (p = 0.021) was also considered as a possible risk factor affecting the value of sodium at admission to hospital. Finally, a negative association was also observed between the degree of hyponatraemia and the duration of hospitalization (z = -3.398, p = 0.001).
Conclusions:
Although studies in larger population groups are needed, in our study increased heart rhythm, tachypnoea, leucocyte count, C-reactive protein, and also erythrocyte sedimentation rate could be considered as possible risk factors influencing the degree of hyponatraemia, and thus the outcome of hospitalized children with CAP.
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