Low serum Sodium levels in children presenting with Pneumonia at a tertiary care hospital

Abstract

Background; Hyponatraemia which is common feature of pneumonia in children leads to significant increase in morbidity, higher ICU admissions and mortality. We studied hyponatremia among hospitalized children with pneumonia at Nishtar Hospital Multan. Objective; Determine the frequency of hyponatremia among hospitalized children suffering from pneumonia.  Material and Methods; The cross-sectional study was conducted at Unit-I Department of Pediatric Medicine, Nishtar Medical University and Hospital, Multan from March 2016 to May 2018. A total of 150 patients with aged 2 – 12 years of either gender with pneumonia were included in our study. All the relevant baseline investigations were done including chest X-Ray were done. History regarding fever, coughing, tachypnea and increased work of breathing. Venous blood sample (3ml) was drawn and sent to laboratory for serum sodium levels analysis. Results; of these 150 study cases, 79 (52.7%) were boys and 71 (47.3%) were girls. Mean age of our study cases was 5.77 ± 2.49 years.  Majority of our patients i.e. 111 (74%) had community acquired pneumonia while hospital acquired pneumonia was in only 26 % of our study cases. Hypotonic intravenous fluid therapy was noted in 16 (10.7%) of our study cases. Mean disease duration of our study cases was 9.05 ± 2.55 days. Frequency of ICU admission was noted in 28 (18.7%) of our study cases. Mean serum sodium level was noted to be 136.43 ± 2.68 nmol/L. Hyponatremia was present in 33 (22%) of our study cases. Conclusion; Frequency of hyponatremia in children with pneumonia was high in our study cases. Hyponatremia was significantly associated with hypotonic fluid therapy, prolonged hospital stay and ICU admission. Hyponatremia is generally neglected while treating pediatric pneumonia so pediatricians must check Serum sodium levels on routine basis among this targeted population which will help to reduce morbidity and adverse clinical outcomes.

Keywords; Hyponatremia, Pneumonia, Serum sodium.