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Hyponatremia Increases Pneumonia Severity in Hospitalized Children

Although previous studies have already established that low serum sodium levels commonly occur in critically ill children who require hospitalization, a team of Polish researchers aimed to more closely evaluate the link between hyponatremia and the severity of a child’s community-acquired pneumonia (CAP).
 
In their recent “Hyponatremia in Children Hospitalized Due to Pneumonia” clinical study published in Neurobiology of Respiration, Teresa Jackowska, MD, PhD, and colleagues from the pediatrics department at Bielański Hospital in Warsaw, Poland, conducted a retrospective analysis of the medical records of 312 children between the ages of 33 days and 16 years who had been hospitalized with CAP. 

The authors divided the pediatric patients into two groups under and over the age of four and used “breath frequency, heart rate, capillary blood saturation, body temperature, time for defeverscence, duration of antibiotic treatment and hospital stay, and the serum inflammatory markers neutrophil count, C-reactive protein (CRP), and procalcitonin level” to predict CAP disease severity.
 
According to the study results, hyponatremia was observed in 104 of the 312 children hospitalized with CAP. The researchers’ completed analysis showed that regardless of age, the hyponatremic children had higher neutrophil counts, “higher CRP and tended to have higher procalcitonin than children without hyponatremia, (and) body temperature was higher and duration of hospitalization was longer in hyponatremic (children) compared with non-hyponatremic children.” However, the investigators found no correlation between the patients’ serum sodium levels and “either breath frequency, heart rate, capillary blood saturation, time for defeverscence, or time of antibiotic treatment.”
 
Nevertheless, the authors concluded that hyponatremia is a “frequent finding in CAP and seems associated with the disease severity” in hospitalized children — a conclusion also drawn by a smaller pediatric CAP population analysis published in the August 2010 issue of the Archives of Medical Science, which similarly noted that neutrophil count and C-reactive protein “could be considered possible risk factors influencing the degree of hyponatremia, and thus the outcome of hospitalized children with CAP.”


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Kevin Skole, MD is a board-certified gastroenterologist practicing in central New Jersey, part of the gastroenterology division of Princeton Healthcare Affiliated Physicians, a multi-specialty medical practice based out of the University Medical Center of Princeton at Plainsboro (see www.princetonhcs.org). He discusses the increased incidence, risk factors, and prevention of Clostridium Difficile (C. diff) infection.
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