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Dysnatremias in pediatric victims of the 2023 Türkiye-Syria earthquake
Ulas Ozdemir1, Tugba Kandemir Gulmez2, Mehmet Deniz Erhan3
1Pediatrics, Adana City Training and Research Hospital, Adana, Turkey. ulasozdemirmd@gmail.com.
Insights
Dysnatremia, or abnormal sodium levels, is common in pediatric earthquake survivors. It is linked to higher rates of complications like crush syndrome and acute kidney injury, highlighting the need for careful monitoring.
Area of Science:
- Pediatric Emergency Medicine
- Disaster Medicine
- Pediatric Nephrology
Background:
- Dysnatremia is a frequent electrolyte disturbance in children.
- Its occurrence and effects in pediatric earthquake survivors remain understudied.
- This research investigates dysnatremia in children impacted by the 2023 Türkiye-Syria earthquakes.
Purpose of the Study:
- To determine the prevalence of dysnatremia in pediatric earthquake victims.
- To assess the association between dysnatremia and adverse outcomes such as complications, mortality, and morbidity.
Main Methods:
- A retrospective analysis of 312 pediatric patients admitted post-earthquake.
- Patients classified as hyponatremic (<135 mmol/L), hypernatremic (>145 mmol/L), or normal (135-145 mmol/L).
- Evaluation of demographic, clinical, and laboratory data.
Main Results:
- Dysnatremia affected 53.5% of patients (36.2% hyponatremic, 17.3% hypernatremic).
- Hyponatremic patients showed higher rates of fasciotomy, crush syndrome (CS), acute kidney injury (AKI), and dialysis.
- Hypernatremic patients experienced significantly longer entrapment times under rubble.
Conclusions:
- Dysnatremia is a prevalent condition among pediatric earthquake survivors.
- The presence of dysnatremia correlates with increased morbidity, specifically CS and AKI.
- Close monitoring and prompt management of sodium imbalances are vital for this patient group.
Background:
Dysnatremia is a common electrolyte abnormality in children, but its prevalence and impact in pediatric earthquake victims are not well established. This study aimed to define the frequency of dysnatremia in pediatric earthquake victims and evaluate its relationship with complications, mortality, and morbidity.
Methods:
We retrospectively analyzed data from 312 pediatric patients admitted to our hospital after the 2023 Türkiye-Syria earthquakes. Patients were categorized based on admission sodium levels: hyponatremic (< 135 mmol/L), hypernatremic (> 145 mmol/L), and normal (135-145 mmol/L). Demographic, clinical, and laboratory data were analyzed.
Results:
Of the 312 patients, 36.2% were hyponatremic, 17.3% were hypernatremic, and 46.5% had normal sodium levels. The frequency of fasciotomy, crush syndrome (CS), acute kidney injury (AKI), and dialysis treatment was significantly higher in the hyponatremic patient group compared to those with normal sodium levels (p < 0.001). Hypernatremic patients also had a longer time under the rubble at 121 ± 64 h, compared to 35 ± 41 h in patients with normal sodium (p < 0.001). Mortality was 5.4%, with no significant difference between dysnatremic and normonatremic patients.
Conclusions:
Dysnatremia is common in pediatric earthquake victims. Dysnatremia is associated with increased morbidity, including CS and AKI. Monitoring and management of sodium abnormalities are crucial in the care of pediatric earthquake survivors.
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