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Hyponatremia in children hospitalized due to pneumonia
1Department of Pediatrics, Medical Center of Postgraduate Education, 99/103 Marymoncka St., 01-813, Warsaw, Poland.
Insights
Hyponatremia, a common finding in pediatric community-acquired pneumonia (CAP), is linked to increased disease severity. This study found hyponatremic children experienced higher fever and longer hospital stays, indicating a more severe illness.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Chemistry
Background:
- Community-acquired pneumonia (CAP) is a significant cause of childhood hospitalization.
- Hyponatremia (low serum sodium) is a common electrolyte imbalance observed in various pediatric illnesses.
Purpose of the Study:
- To investigate the association between hyponatremia and the severity of community-acquired pneumonia in children.
- To identify clinical and laboratory markers of disease severity in pediatric CAP patients with and without hyponatremia.
Main Methods:
- Retrospective analysis of medical records for 312 children hospitalized with CAP.
- Patients were categorized by age (under/over four years) and presence of hyponatremia.
- Disease severity was assessed using clinical parameters (temperature, respiratory rate, saturation) and inflammatory markers (WBC, neutrophils, CRP, procalcitonin).
Main Results:
- Hyponatremia was present in 33.3% of the pediatric CAP cohort.
- Hyponatremic children exhibited higher body temperatures and prolonged hospitalizations.
- Elevated inflammatory markers, including neutrophils and C-reactive protein (CRP), were observed in hyponatremic patients, suggesting increased inflammation and disease severity.
Conclusions:
- Hyponatremia is a frequent complication of pediatric CAP.
- The presence of hyponatremia in children with CAP is associated with indicators of increased disease severity.
- Further research may explore the underlying mechanisms and clinical implications of hyponatremia in pediatric CAP.
Abstract:
The aim of this study was to evaluate the relation between hyponatremia (HN) and severity of community-acquired pneumonia (CAP) in children. The study consisted of a retrospective analysis of medical records of 312 children (165 boys, 147 girls) aged 33 days to 16 years, hospitalized with CAP. The children were divided into two age-groups: under and over the age of four. Clinical findings such as breath frequency, heart rate, capillary blood saturation, body temperature, time for defeverscence, duration of antibiotic treatment and hospital stay, and the serum inflammatory markers WBC, neutrophil count, CRP, and procalcitonin level were used as the disease severity predictors. The results demonstrate that hyponatremia was observed in 104/312 (33.3 %) patients. Children with HN of both age-groups had higher neutrophil counts (6.96 vs. 5.73*10(3)/μL; p < 0.05 and 12.46 vs. 8.22*10(3)/μL; p = 0.01), those aged > 4 had higher WBC (15.85 vs. 11.0*10(3)/μL; p = 0.02), and those aged < 4 had a lower lymphocyte count (3.74 vs. 4.75*10(3)/μL; p = 0.02) than children without HN. Hyponatremic children had higher CRP (28.82 mg/L vs. 9.18 mg/L; p < 0.01) and tended to have higher procalcitonin (0.31 vs. 0.19 ng/mL) than children without HN. Body temperature was higher (38.6 vs. 37.6 °C; p < 0.01) and duration of hospitalization was longer (9 vs. 8 days, p = 0.01) in hyponatremic compared with non-hyponatremic children. There was no correlation between the sodium level and either breath frequency, heart rate, capillary blood saturation, time for defeverscence, or time of antibiotic treatment. We conclude that hyponatremia is a frequent finding in CAP and seems associated with the disease severity.
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