Sajjad Hussain, Sajjad Hussain, Mumtaz Hassan.
Management of Hypernatremic Dehydration and its outcome in children.
Pak Paed J Jan ;27(3):121-6.

Objective: To study outcome of early detection and slow proper rehydration in hypernatremic dehydration. Introduction:- Diarrhoeal diseases are one of the leading causes of morbidity and mortality in children. Large net losses of water compared with losses of electrolytes, result in hypernatremic dehydration. It is seen in approximately 1020% of patients with diarrhea. Hypernatremia is associated with high mortality rate if the serum sodium concentration exceeds 158 m Eq/L. Methods:- This was a prospective study over 8 months (January to August 2003), conducted in Isolation Ward of the Children`s Hospital, PIMS, Islamabad. The enrollment criteria included all children having diarrhea of less than 2 weeks and serum sodium level greater than 150mEq/L. After enrollment all children were given initially, half normal saline with 5% D/W (N/2) for 10 to 12 hours, followed by one fifth normal saline (N/5) for the next 48 -- 72 hours. Results:- During the study period, we enrolled 42 children of acute gastroenteritis with hypernatremia. Twenty nine (69.1%) children were male. The male to female ratio was 2.2:1. The mean age of these children was 8.07 ± 5.1 months. Twenty nine (69.1%) children were breast fed. Thirty six (85.7%) children had history of ORS ingestion. Mean serum sodium level at enrollment was 158.3 ± 3.9 mEq/L and after 72 hours of treatment it was 144.2 ± 2.6 mEq/L. The mean duration of treatment was 3.0 ± 0.4 days. After 72 hours of IV therapy, only 2 (4.8%) children expired. Conclusion:- In most children hypernatremic dehydration could be prevented by providing parental awareness regarding careful assessment of stools in breast fed infants and proper preparation and use of ORS in diarrhea.

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