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Hiponatremia sintomática durante el tratamiento de la enfermedad diarrea deshidratante con solución de rehidratación
Nur H Alam1, Mohammed Yunus, Abu S G Faruque
1Clinical Sciences Division, International Centre for Diarrhoeal Disease Research Bangladesh, Mohakhali, Dhaka, Bangladesh. nhalam@icddrb.org
JAMA
|August 3, 2006
Resumen
La nueva solución de rehidratación oral de osmolaridad reducida (SRO) es segura para el tratamiento de la diarrea. Las tasas de hiponatremia sintomática fueron mínimas y disminuyeron en comparación con la formulación anterior.
Área de la Ciencia:
- Salud Pública La salud pública.
- La pediatría es la medicina de los niños.
- La medicina clínica es la medicina clínica.
Sus antecedentes:
- La Organización Mundial de la Salud y UNICEF recomendaron una solución de rehidratación oral (SRO) de osmolaridad reducida en 2002.
- Se aconsejó monitorear la seguridad de la nueva formulación de ORS, específicamente la hiponatremia sintomática.
Objetivo del estudio:
- Para medir la incidencia de hiponatremia sintomática en pacientes tratados con el ORS de osmolaridad reducida.
- Para comparar las tasas de hiponatremia con la formulación ORS anterior.
Principales métodos:
- Un ensayo de fase 4 se llevó a cabo en Bangladesh desde diciembre de 2002 hasta enero de 2004.
- Los pacientes con diarrea acuosa sin complicaciones recibieron el ORS de osmolaridad reducida y fueron monitoreados para detectar síntomas neurológicos.
- Se revisaron los registros del hospital de Dhaka del año anterior utilizando la antigua formulación de ORS para su comparación.
Principales resultados:
- Más de 53.000 pacientes fueron monitoreados; 24 desarrollaron convulsiones o alteración de la conciencia asociada con hiponatremia.
- La tasa de incidencia de hiponatremia sintomática fue del 0,05% en Dhaka y del 0,03% en Matlab.
- Esto representa una reducción estadísticamente significativa en comparación con la tasa del año anterior del 0,10%.
Conclusiones:
- El riesgo de hiponatremia sintomática con ORS de osmolaridad reducida es mínimo.
- El cambio en la formulación del ORS no aumentó el riesgo de hiponatremia.
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