Hyponatremia in children: summary and quick guide to its implications in anesthesia.

Authors

  • Rubén Ferreras Vega Medical specialist. Pediatric anesthesia, resuscitation and pain therapy, 12 de Octubre hospital, Madrid.
  • María Dolores Méndez Marín Medical specialist. Pediatric anesthesia, resuscitation and pain therapy, 12 de Octubre hospital, Madrid.
  • Paloma Rubio Pascual Head of Pediatric Anesthesia, Resuscitation and Pain Therapy Service, 12 de Octubre Hospital, Madrid.

DOI:

https://doi.org/10.30445/rear.v12i12.877

Keywords:

hiponatremia, hyponatremia, adh, siadh, cerebral salt wasting syndrome, cerebral salt wasting, síndrome pierde sal cerebral, spsc, sodium dysorders, sodium, sodio, trastornos del sodio, dysnatermia, disnatremias, anestesia pediátrica, trastornos del sodio en niños, children sodium disorders

Abstract

Introduction

Due to hyponatremia frequency  a wide range of guidelines for the management of sodium disorders have been plublished. Nevertheless, this review has been made with the aim of summarize the hyponatremia pathophysiology in children, focused on its anesthetic implications.

Methods:

The review is composed by information extracted from 2 clinical guidelines, 12 papers.

Description:

Mathematical calculations are commonly used in sodium disorders management. SIADH and Cerebral salt wasting can cause hyponatremia in children. Algorithms help us to differentiate the main pathologies to achieve a correct diagnosis. The sodium correction should not be done aggressively in order to avoid complications.

Conclusions:

New technologies such as phone apps and specific recomendations for infants in periopetaive period could help to manage dysnatremia.

 

References

- Upadhyay A, Jaber BL, Madias NE. Incidence and prevalence of hyponatremia. Am J Med. 2006; 119:S30-5. DOI: 10.7861/clinmedicine.17-3-263

- Adrogue, H.J and Madias, N.E. Hyponatremia N Eng J Med; 2000: 342:1581-1585. PMID: 10824078 DOI: 10.1056/NEJM200005253422107

- Berl T. The Adrogué–Madias formula revisited. Clin J Am Soc Nephrol; 2007: 1098–1099 PMID: 17928464 DOI: 10.2215/CJN.03300807

- Tomlinson B.E., Pierides A.M., Bradley W.G. (1976) Central pontine myelinolysis. Q J Med 179: 373–386. PMID: 948540

- Sterns R.H., Riggs J.E., Schochet S.S. (1986) Osmotic demyelination syndrome following correction of hyponatremia. N Engl J Med; 1986: 314: 535–542. PMID: 3713747 DOI: 10.1056/NEJM198606123142402

- Upadhyay A, Jaber BL, Madias NE. Incidence and prevalence of hyponatremia. Am J Med Am J Med. 2006;119(7 Suppl 1):S30-5. PMID: 16843082 DOI: 10.1016/j.amjmed.2006.05.005

- Ellis S.J. Severe hyponatremia: complications and treatment. Q J Med; 1995: 88: 905–909 PMID: 8593551

- Arieff AI, Gabbai R, Goldfine ID. Cerebral Salt-Wasting Syndrome: Diagnosis by Urine Sodium Excretion. Am J Med Sci. 2017;354(4):350-354. DOI: 10.1016/j.amjms.2017.05.007.

- Way C, Dhamrait R, Wade A, Walker I. Perioperative fluid therapy in children: a survey of current prescribing practice. Br J Anaesth. 2006 S;97(3):371-9. PMID: 16873386 DOI: 10.1093/bja/ael185

- Neville KA, Sandeman DJ, Rubinstein A, Henry GM, McGlynn M, Walker JL. Prevention of hyponatremia during maintenance intravenous fluid administration: a prospective randomized study of fluid type versus fluid rate. J Pediatr. 2010;156(2):313-9. DOI: 10.1016/j.jpeds.2009.07.059 PMID: 19818450

- Sterns RH. Evidence for Managing Hypernatremia: Is It Just Hyponatremia in Reverse? Clin J Am Soc Nephrol. 2019 7;14(5):645-647 PMCID: PMC6500936 DOI: 10.2215/CJN.02950319
12. Hirsch IA, Tomlinson DL, Slogoff S: The overstatedrik of preoperative hypokalemia Anesth Analg 198867: 131-136. PMID: 3341565

Lecturas recomendadas
https://www.nefrologiaaldia.org/es-articulo-trastornos-del-agua-disnatremias-197
Guías clínicas
http://secip.com/wp-content/uploads/2018/06/Protocolo-SIADH-Diabetes-Insipida-SDR-Pierde-Sal.pdf
Calculadoras de interés
http://www.samiuc.es/reposicion-sodica-las-hiponatremias/

Published

2021-01-11

How to Cite

Ferreras Vega, R., Méndez Marín, M. D., & Rubio Pascual, P. (2021). Hyponatremia in children: summary and quick guide to its implications in anesthesia. Revista Electrónica AnestesiaR, 12(12). https://doi.org/10.30445/rear.v12i12.877