Syndrome of inappropriate antidiuretic hormone secretion [SIADH] in a pediatric ICU

ABSTRACT

Fifty hyponatremic children were recruited from those who have been admitted to the pediatric intensive care unit [PICU] at Ain Shams University hospitals in a 4 month period. Their ages ranged between 5 months and 9 years. They were 27 males and 23 females. The fifty cases were categorized under 3 clinical groups; pneumonia [19], status asthmaticus [17] and meningitis [14]. All cases were subjected to measurement of serum and urinary sodium as well as serum and urine osmolality in addition to clinical and laboratory evaluation of the underlying disease. It was found that SIADH is a common cause of hyponatermia in the PICU [60%] with more prevalence among cases of meningitis group. However severity of SIDAH does not vary with the cause or severity of the underlying disease. We conclude that SIADH should be considered a common problem in PICU especially among hyponatermic cases. Therefore routine measurement of urinary sodium and osmolalities of both serum and urine are recommended in hyponatremic cases admitted to PICU so as to pick up those who would pass to SIADH and hence adequately managed