Hernández ÁCF, García RJF, Valdés LA

Language: Spanish
References: 15
Page: 52-60
PDF size: 105.31 Kb.

ABSTRACT

Introduction: In recent years, there has been an increase in the incidence of hypernatremia in newborns; since it is a condition that could be prevented, and because of its high mortality rate, it was decided to determine the incidence and clinical course of this condition in our hospital. Objective: To determine the risk factors and clinical course of infant patients with hypernatremic dehydration in the Hospital for Children (HPN), IMIEM. Material and methods: Cross-sectional, longitudinal and retrospective study. We collected the records of those patients diagnosed with hypernatraemic dehydration in the neonatology service at the IMIEM Hospital for Children, from January 1, 2007 to March 31, 2012. Clinical and laboratory values were obtained to determine their clinical course and remission. Results: Seventy-eight cases were obtained, of which 63 met the inclusion criteria. The average age of the patients was 10.2 days; 63% were female and 37% male. 75% of infants were born from a full-term pregnancy. 71% were obtained by vaginal delivery and 87% were exclusively breastfed. Upon admission, 73% of the patients showed clinical symptoms of dehydration, with a mean weight loss from birth to their admission of 15 %, and a gain from admission to discharge of 12%. Metabolic and non-metabolic complications were found, hypoglycemia and hyperbilirubinemia being the most common metabolic complications; 14% developed sepsis during their stay. 10% required mechanical ventilatory support. The most common non-metabolic complications were cerebral edema, in 5% of patients, and seizures, in 3%; only one newborn developed intraventricular hemorrhage grade I. Conclusion: Proper identification of risk factors and the appropriate correction of sodium lowers the risk of metabolic and non- metabolic complications in the newborn.

REFERENCES

1. Peñalver GO, Gisbert MJ, Casero SJ, Bernal FA, Oltra BM, Tomás VM. Deshidratación hipernatrémica asociada a lactancia materna, An Pediatr (Barc), 2004; 61 (4): 340-343.

2. Laing A, Wong C. Hypernatraemia in the first few days: is the incidence rising? Arch Dis Child Fetal Neonatal, 2002; 87 (3): F158-F162.

3. Moritz ML, Ayus JC. Disorders of water metabolism in children: hyponatremia and hypernatremia, Pediatri Rev, 2002; 23 (11): 371-380.

4. Moritz ML, Manole MD, Bogen DL, Ayus JC. Breastfeeding-associated hypernatremia: are we missing the diagnosis? Pediatrics, 2005; 116 (3): e343-e347.

5. Asturizaga MA, Mazzi GE. Hipernatremia neonatal: factores de riesgo, Rev Chil Pediatr, 2011; 82 (2): 150-151.

6. Segovia RE. Hiponatremia e hipernatremia. En: Bases de la medicina clínica. Para estudiantes de Medicina. Facultad de Medicina. Universidad de Chile. Disponible en: http://www.basesmedicina.cl/nefrologia/12_3_hiponatremia/inicio.htm

7. Solá A, León HAP. Balance hidroelectrolítico. 2013. Disponible en: http://www.docstoc.com/docs/153840669/Balance-Hidroelectrol%C3%ADtico-Neonatal

8. Musapasaoglu H, Agildere AM, Teksam M, Tarcan A, Girakan B. Hypernatraemic dehydration in neonate: brain MRI findings, Br J Radiol, 2008; 81 (962): e57-e60.

9. Tofé VI, Párraga AMJ, Ruiz GMD, Huertas MMD, Guzmán CJM, Zapatero MM. Deshidratación hipernatrémica en un recién nacido con lactancia materna exclusiva, Vox Paediatrica, 2005; 13 (1): 39-41.

10. Adrogué HJ, Madias NE. Hypernatremia, N Engl J Med, 2000; 342: 1493-1499.

11. Scardapane S, Jugo M, Muñoz MA, Delgado E, González YA. Deshidratación hipernatrémica del recién nacido, implementación de nueva estrategia para su reconocimiento precoz. Servicio de Neonatología del Hospital Interzonal Dr. José Penna de Bahía Blanca. Disponible en: http://www.hospitalpenna.com.ar/archivos/jornadas _2008/13.pdf

12. Islas DLP, Ortiz AR, Verduzco GM. Causas de reingreso a un hospital de recién nacidos egresados tempranamente, Rev Mex Ped, 2003; 70 (5): 243-245.

13. Albalate RM, Alcázar AR, De Sequera OP. Alteraciones del sodio y del agua [acceso 4 de diciembre de 2012]. En: Nefrología al día. Trastornos electrolíticos y ácido-base. doi: 10.3265/Nefrologia.2010.pub1.ed80.chapter2796. Disponible en: http://nefrologiadigital.revistanefrologia.com/modules.php?name=libro&op=viewCapNewVersion&idpublication=1&idedition=80&idcapitulo=2796&idversion=&wordsearch=

14. Juliao J. Deshidratación hipernatrémica e hiperbilirrubinemia indirecta en el recién nacido a término, Rev Medica Sanitas, 2009; 12 (4): 34-42.

15. Alegría PX. Manejo hidrolectrolítico en el recién nacido. Disponible en: http://http://200.72.129.100/hso/guiasclinicasneo/10_Trastornos_Hidroelectroliticos.pdf