Water and electrolyte status in children with acute asthma

The water and electrolyte status was studied in 26 children with acute asthma, 8 of whom required hospital admission. Patients were evaluated before therapy, during hospital management, and at least 10 days after symptoms had subsided. Laboratory evaluation included serum electrolytes, BUN, sOsmo, urinalysis, and uOsmo. Data were analyzed for the manifestations of SI-ADH. Mild serum hyposmolarity was noted initially in only two patients and during the hospital stay in one patient for a short time, but none of the patients fulfilled the criteria of SIADH. At the time of presentation at the emergency room, none of the 26 patients had clinical signs of dehydration, yet some degree of hypertonicity seemed to be present in most patients. This study shows that children with acute asthma are ordinarily not at high risk of SIADH and fluid therapy should be included in the management. Nevertheless, because such patients may be at risk of pulmonary edema, vigorous fluid administration should be discouraged, except to correct dehydration.