Prognosis of Severe Diarrhea Associated with Hypernatremia in Children / 实用儿科临床杂志

ABSTRACT

Objective To evaluate the factors in relation to prognosis of severe diarrhea associated with hypernatremia in children.Methods The medical records of severe diarrhea and hypernatremia admitted to pediatric intensive care unit(PICU) from January 2000 to December 2004 reviewed retrospectively.The relationship between prognosis and serum sodium peak level,severity of diseases,treatment strategies were analyzed in 63 children with severe diarrhea associated with hypernatremia.Results There were 169 severe diarrhea and 85 hypernatremia cases during the study period.In the 169 severe diarrhea children,63 were associated with hypernatremia(37.28%) and accounted for 74.12% of all 85 hypernatremia cases admitted to our PICU.The mean pediatric critical illness score(PCIS) was(75.50?6.83) score in survival group and(60.75?5.34) score in mortality group,with significant statistical difference((t=)5.86 P0.05).All the children were cured when the reduction rate of serum sodium concentration was between 0.5-1.0 mmol/(L?h).Signs of cerebral edema developed in 8 children and 5 of 8 died when the reduction rate of serum sodium concentration was between 1.2-2.4 mmol/(L?h).Conclusions Severe diarrhea associated with hypernatremia is common in children and is the major cause of hypernatremia in critically ill child.The key to determine the prognosis of severe diarrhea with hypernatremia in children is the severity of disease and the strategies of treatment.