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Hypernatraemic dehydration in infants in Kuwait with special reference to therapy of associated metabolic acidosis
Insights
Hypernatraemic dehydration in infants with diarrhea is a serious condition. Prompt treatment with intravenous fluids and sodium bicarbonate can lead to recovery without long-term neurological issues.
Area of Science:
- Pediatrics
- Neonatal Care
- Clinical Medicine
Background:
- Diarrhea is a common cause of dehydration in infants.
- Hypernatraemic dehydration poses significant risks, including neurological complications.
- Understanding risk factors and effective management is crucial for infant health.
Purpose of the Study:
- To investigate the incidence and clinical features of hypernatraemic dehydration in infants admitted with diarrhea.
- To evaluate the treatment outcomes and identify potential complications.
Main Methods:
- Retrospective analysis of 510 infants admitted with diarrhea over 16 months.
- Identification of 26 infants (5.1%) who developed hypernatraemic dehydration.
- Review of clinical presentation, treatment protocols, and patient outcomes.
Main Results:
- Hypernatraemic dehydration occurred in 5.1% of infants with diarrhea.
- Common symptoms included vomiting, fever, and convulsions.
- Treatment involved intravenous fluids, sodium bicarbonate, and glucose, with a high survival rate (96.15%) and no neurological sequelae in survivors.
Conclusions:
- Hypernatraemic dehydration is a preventable complication of diarrhea in infants.
- Aggressive management with tailored intravenous fluid therapy is effective.
- Early recognition and treatment are vital for favorable outcomes in affected infants.
Abstract:
Over a period of 16 months 510 children with diarrhoea were admitted to the Al-Adan Hospital, Kuwait, of whom 26 (5.1%) developed hypernatraemic dehydration. Prominent clinical features included vomiting (92.3%), fever (84.6%) and convulsions (19.2%). The majority were below six months of age with a mean age of 3.1 months. The sex distribution was equal. Twenty infants (77%) had severe metabolic acidosis and were treated with a combination of sodium bicarbonate and 5% glucose in water until the acidosis was corrected after which a solution of sodium chloride replaced the use of sodium bicarbonate. The sodium concentration of the intravenous fluid varied from 15 to 30 mmol/l and was given at a rate of 100 to 120 ml/kg/day. One infant died. The 25 survivors, (96.15%), which included three who developed convulsions during treatment, recovered without any neurologic sequelae.