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Association Between Hyponatremia and Higher Bronchiolitis Severity Among Children in the ICU With Bronchiolitis

Kohei Hasegawa1, Michelle D Stevenson2, Jonathan M Mansbach3

  • 1Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; khasegawa1@partners.org.

Hospital Pediatrics
|July 3, 2015
PubMed

Insights

Hyponatremia, or low sodium levels, in infants hospitalized with bronchiolitis is linked to more severe illness. This finding helps predict disease severity in children with bronchiolitis.

Area of Science:

  • Pediatrics
  • Critical Care Medicine
  • Clinical Chemistry

Background:

  • Bronchiolitis is a common respiratory infection in infants.
  • The prognostic value of hyponatremia in pediatric bronchiolitis remains unclear.
  • Hyponatremia may indicate increased disease severity in hospitalized infants.

Purpose of the Study:

  • To investigate the association between hyponatremia and bronchiolitis severity.
  • To determine if hyponatremia independently predicts worse outcomes in children with bronchiolitis.
  • To assess the utility of hyponatremia as a prognostic factor for severe bronchiolitis.

Main Methods:

  • Prospective, 16-center cohort study of children under 2 years with bronchiolitis.
  • Serum sodium levels were measured on admission, classifying patients as normonatremic or hyponatremic.
  • Outcomes included mechanical ventilation use and intensive care unit (ICU) length of stay (LOS), analyzed with propensity score adjustment.

Main Results:

  • Of 231 children, 16% presented with hyponatremia.
  • Hyponatremic children had significantly higher rates of mechanical ventilation (58% vs 40%).
  • Hyponatremia was associated with longer ICU LOS (median 6 days vs 3 days) and increased risk of ventilation (OR 2.14).

Conclusions:

  • Hyponatremia at hospitalization is associated with increased severity of bronchiolitis in children.
  • Low serum sodium levels serve as a prognostic factor for severe disease.
  • Identifying hyponatremia can aid clinicians in predicting the course of bronchiolitis in pediatric patients.
Abstract

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