Treatment of hyponatremia in children with acute bacterial meningitis
PurposeFew studies have evaluated hyponatremia management in children with bacterial meningitis (BM). Thus, we aimed to describe variations in clinical practice, the effectiveness of sodium management, and adverse outcomes in children with BM and hyponatremia.MethodsThis retrospective cross-sectiona...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.911784/full |
| _version_ | 1828149495734468608 |
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| author | Feixia Zheng Feixia Zheng Xiaoyan Ye Yuanyuan Chen Hongying Wang Shiyu Fang Xulai Shi Zhongdong Lin Zhenlang Lin |
| author_facet | Feixia Zheng Feixia Zheng Xiaoyan Ye Yuanyuan Chen Hongying Wang Shiyu Fang Xulai Shi Zhongdong Lin Zhenlang Lin |
| author_sort | Feixia Zheng |
| collection | DOAJ |
| description | PurposeFew studies have evaluated hyponatremia management in children with bacterial meningitis (BM). Thus, we aimed to describe variations in clinical practice, the effectiveness of sodium management, and adverse outcomes in children with BM and hyponatremia.MethodsThis retrospective cross-sectional study conducted at a tertiary institution analyzed participants' demographic, clinical, and sodium-altering treatment data. The sodium trigger for treatment was defined as pretreatment sodium level, with response and overcorrection defined as increments of ≥5 and >10 mmol/L after 24 h, respectively.ResultsThis study enrolled 364 children with BM (age: <16 years; 215 boys). Hyponatremia occurred in 62.1% of patients, among whom 25.7% received sodium-altering therapies; 91.4% of those individuals had moderate/severe hyponatremia. Monotherapy was the most common initial hyponatremia treatment. After 24 h of treatment initiation, 82.4% of the patients responded. Logistic regression analyses revealed that ΔNa24 <5 mmol/L [odds ratio (OR) 15.52, 95% CI 1.71–141.06, p = 0.015] and minimum Glasgow Coma Scale (GCS) score ≤ 8 (OR 11.09, 95% CI 1.16–105.73, p = 0.036) predicted dysnatremia at 48 h after treatment initiation. Although rare, persistent moderate/severe hyponatremia or hypernatremia at 48 h after treatment initiation was associated with a high mortality rate (57.1%).ConclusionThis study found that most cases of hyponatremia responded well to various treatments. It is important to identify and institute appropriate treatment early for moderate or severe hyponatremia or hypernatremia in children with BM. This study was limited by its non-randomized nature. |
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| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-11T21:30:57Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj.art-207d8bceb5ef48f08ea2758075a862002022-12-22T04:01:59ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-08-011310.3389/fneur.2022.911784911784Treatment of hyponatremia in children with acute bacterial meningitisFeixia Zheng0Feixia Zheng1Xiaoyan Ye2Yuanyuan Chen3Hongying Wang4Shiyu Fang5Xulai Shi6Zhongdong Lin7Zhenlang Lin8Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Pediatrics, Aksu First People's Hospital, Xinjiang, ChinaDepartment of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Pediatrics, Aksu First People's Hospital, Xinjiang, ChinaDepartment of Pediatrics, Aksu First People's Hospital, Xinjiang, ChinaDepartment of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaPurposeFew studies have evaluated hyponatremia management in children with bacterial meningitis (BM). Thus, we aimed to describe variations in clinical practice, the effectiveness of sodium management, and adverse outcomes in children with BM and hyponatremia.MethodsThis retrospective cross-sectional study conducted at a tertiary institution analyzed participants' demographic, clinical, and sodium-altering treatment data. The sodium trigger for treatment was defined as pretreatment sodium level, with response and overcorrection defined as increments of ≥5 and >10 mmol/L after 24 h, respectively.ResultsThis study enrolled 364 children with BM (age: <16 years; 215 boys). Hyponatremia occurred in 62.1% of patients, among whom 25.7% received sodium-altering therapies; 91.4% of those individuals had moderate/severe hyponatremia. Monotherapy was the most common initial hyponatremia treatment. After 24 h of treatment initiation, 82.4% of the patients responded. Logistic regression analyses revealed that ΔNa24 <5 mmol/L [odds ratio (OR) 15.52, 95% CI 1.71–141.06, p = 0.015] and minimum Glasgow Coma Scale (GCS) score ≤ 8 (OR 11.09, 95% CI 1.16–105.73, p = 0.036) predicted dysnatremia at 48 h after treatment initiation. Although rare, persistent moderate/severe hyponatremia or hypernatremia at 48 h after treatment initiation was associated with a high mortality rate (57.1%).ConclusionThis study found that most cases of hyponatremia responded well to various treatments. It is important to identify and institute appropriate treatment early for moderate or severe hyponatremia or hypernatremia in children with BM. This study was limited by its non-randomized nature.https://www.frontiersin.org/articles/10.3389/fneur.2022.911784/fullhypernatremiapediatricprognosistreatmentdysnatremia |
| spellingShingle | Feixia Zheng Feixia Zheng Xiaoyan Ye Yuanyuan Chen Hongying Wang Shiyu Fang Xulai Shi Zhongdong Lin Zhenlang Lin Treatment of hyponatremia in children with acute bacterial meningitis Frontiers in Neurology hypernatremia pediatric prognosis treatment dysnatremia |
| title | Treatment of hyponatremia in children with acute bacterial meningitis |
| title_full | Treatment of hyponatremia in children with acute bacterial meningitis |
| title_fullStr | Treatment of hyponatremia in children with acute bacterial meningitis |
| title_full_unstemmed | Treatment of hyponatremia in children with acute bacterial meningitis |
| title_short | Treatment of hyponatremia in children with acute bacterial meningitis |
| title_sort | treatment of hyponatremia in children with acute bacterial meningitis |
| topic | hypernatremia pediatric prognosis treatment dysnatremia |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.911784/full |
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