Factores de riesgo asociados a deshidratación hipernatrémica neonatal / Risk factors associated with neonatal hypernatremic dehydration

Introducción: La deshidratación hipernatrémica neonatal es un problema creciente, en la que la alimentación y los conocimientos sobre cuidados del recién nacido juegan un papel primordial. Objetivo: Determinar los factores de riesgo asociados a la deshidratación hipernatrémica en neonatos. Métodos: Estudio observacional descriptivo retrospectivo en una población de 20 neonatos con deshidratación hipernatrémica ingresados en el servicio de cuidados intermedios de un hospital de Lima, Perú entre junio 2017- septiembre 2018. Todos tenían concentraciones de sodio sérico≥150 mmol/L. La recolección de la información se extrajo de las historias clínicas. Resultados: De los 20 neonatos con deshidratación hipernatrémica; los nacidos por cesárea equivalen a 30 por ciento, mientras que por parto vaginal, a 70 por ciento de los casos. Se demostró que hay una relación inversa entre número de gestación y concentraciones de sodio al ingreso, sin embargo, no hubo significación estadística. Se logró una disminución entre sodio de entrada y su primer control, con una media de disminución de 0,57 meq/L/h. Clínicamente los neonatos afectados desarrollaron en mayor porcentaje ictericia y fiebre. No se encontró relación significativa entre el resto de los factores asociados. Conclusiones: Entre los factores de riesgo asociados a la deshidratación hipernatrémica, destaca que el grupo nacidos por cesárea fue menor que los nacidos por parto vaginal, lo que influye en el número de altas precoces al nacimiento. Ictericia y fiebre continúan siendo las características clínicas que debe identificarse tempranamente. Se trata de un cuadro prevenible si se brinda adecuada información a la madre sobre cuidado neonatal(AU)

Introduction: Neonatal hypernatremic dehydration is a growing problem, in which feeding and knowledge about newborn care play a key role. Objective: To determine the risk factors associated with hypernatremic dehydration in neonates. Methods: Retrospective descriptive observational study in a population of 20 neonates with hypernatremic dehydration admitted to the intermediate care service of a hospital in Lima, Peru between June 2017 and September 2018. All of them had serum sodium concentrations≥150 mmol/L. The collection of information was extracted from medical records. Results: Of the 20 neonates with hypernatremic dehydration, those born by cesarean section are equivalent to 30 , while by vaginal delivery, 70% of cases. It was shown that there is an inverse relationship between gestation number and sodium concentrations at admission, however, there was no statistical significance. A decrease was achieved between input sodium and its first control, with a mean decrease of 0.57 meq/L/h. Clinically, the affected neonates developed a higher percentage of jaundice and fever. No significant relationship was found between the rest of the associated factors. Conclusions: Among the risk factors associated with hypernatremic dehydration, it stands out that the group born by cesarean section was lower than those born by vaginal delivery, which influences the number of early discharges at birth. Jaundice and fever continue to be the clinical features that should be identified early. This is a preventable condition if adequate information is provided to the mother about neonatal care(AU)

Clinical Profile and Outcome of Neonates with Hypernatremic Dehydration - A Tertiary Care Hospital based Study

Introduction: Neonatal hypernatremic dehydration is amedical emergency. Early diagnosis and appropriate treatmentis crucial for survival and better prognosis. However, diagnosisis often difficult due to apparent well being and dehydration isunderestimated. The aim of our study was to see the outcomeof neonates admitted with hypernatremic dehydration in ourhospitalMaterial and Methods: The study was conducted inneonatology of Postgraduate Department of Pediatrics, inGB Pant Hospital, an associated hospital of GovernmentMedical College Srinagar. It was a hospital based prospectiveobservational study conducted for 1 year, from March 2016to February 2017. A total of 67 neonates were enrolled in ourstudy.Results: The results showed mean age of presentation 18days, females were 37(55.5%), mean birth order was 1.6,44(65.7%) cases were from rural background,62 (92.5%) ofour cases were term babies, an average weight loss of 14.6%was found. There was a significant statistical relation in thepercentage of weight loss, incidence of shock, incidence ofAKI and sodium levels(p value<0.001).Conclusion: Women should be educated about theproper technique of breast feeding during prenatal visitsand after the delivery of the newborn. Mothers should beinformed about ‘ten steps of successful breast feeding’.All breast-fed infant should be weighed at least onceseveral days after discharge

Severe hypernatremic dehydration in a breast-fed neonate / 소아과

Although it is a rare condition, breast-feeding may result in hypernatremic dehydration. However, incidences might be increasing with more mothers breast-feeding. Although the early detection and management of hypernatremic dehydration from breast-feeding is important, its prevention is even more important on account of its serious complications. In order to prevent hypernatremic dehydration secondary to breast-feeding, it is essential to educate mothers in successful breast-feeding methods. An early follow-up after discharge is recommended. We report a case of hypernatremic dehydration secondary to breast-feeding in a full-term newborn that was corrected without any complications.