Background: Dysnatremia is relatively common in critically ill patients. The prevalence of sodium disturbances in PICU changes from 20% to 30%. These disorders and their treatment are accompanied by increased mortality and morbidity.
Aim and objectives: The aim of this study was to determine the prevalence of dysnatremia in children hospitalized at PICU of Al-Zahraa University Hospital and its relation to outcome.
Patient and methods: This was a retrospective observational study that was carried out at the pediatric intensive care unit of Al-Zahraa University Hospital (PICU), Faculty of Medicine for girls Al-Azhar University. The study carried out on 1011 children admitted at PICU from January 2016 to December 2019, both sexes were included with an age range between 1 month to12 years. All data extracted from the hospital database and medical records, exporting demographic data, and diagnosis. Serum sodium was checked on admission and concentrations below 135 and above 145 mEq/L were considered hyponatremia and hypernatremia respectively, outcome data including survival status at PICU, period of hospital stay and respiratory support in the form of CPAP and Mechanical ventilation.
Results: The study included 1011 patients where the most common cause of admission at PICU was respiratory tract disorders. The Prevalence of dysnatremia (hyponatremia and hypernatremia was (18.4%) and (2.6%) respectively). The Prevalence of dysnatremia was insignificant between gender, but there was a statistically significant difference in age between isonatremic and hyponatremic patients. Cardiac diseases were statistically significant increase in hyponatremic patients in comparison to Isonatremic patients (p=0.033), Gastroenteritis and CNS infections were statistically significantly increased in hypernatremic patients in comparison to isonatremic patients (p=0.000) (p=0.010) respectively, Dysnatremia was associated with prolonged hospital stay (hyponatremia median was 5(3-8) days, hypernatremia median was 5 (4-8) days with (p=0.007), (p=0.015) respectively). There was no statistically significant difference between dysnatremic and isonatremic patients regarding mortality.
Conclusion: Hyponatremia was more prevalent in critically ill children than hypernatremia. The most common cause of admission in PICU was respiratory tract disorders. Dysnatremia was associated with increased duration of hospital stay.