Clinical Profile and Early Outcomes of Neonates With Hypernatremic Dehydration in a Neonatal Intensive Care Unit...

Hypernatremic dehydration in neonates is a preventable but potentially fatal condition and often results from inadequate breastfeeding or inappropriate feeding methods. If not identified and managed promptly, it can result in serious complications such as acute kidney injury (AKI), intra-cranial hemorrhage, thrombosis, and increased risk of mortality.

A prospective observational study was conducted over one year in the neonatal intensive care unit (NICU) of a tertiary hospital. Neonates with signs and symptoms of dehydration with serum sodium >145 mEq/L were included. Data was collected on demographic characteristics, clinical presentation, feeding practices, complications, and outcomes. Statistical analysis was done using chi-square test.

Out of 60 neonates, 58.3% were preterm and 83.3% were low birth weight. Top feeding was observed in 66.6%. Common presentations were diarrhea (63%), refusal to feed (45%), and lethargy (30%). Complications included AKI (38.3%), intracranial bleed (8.3%) and thrombosis (8.3%). Mortality rate was 28.3%, significantly associated with AKI (p=0.0033), intracranial hemorrhage (p=0.0199), top feeding (p=0.034), and sodium >170 mEq/L (p=0.0051).

Hypernatremic dehydration in neonates is associated with modifiable risk factors and has high complication rates. Proper feeding practices with emphasis on breastfeeding and early clinical recognition are critical in reducing mortality.