Hypernatraemic dehydration in acute gastroenteritis a descriptive audit of the pre hospital management and predisposing factors in children
Date
2017
Authors
Hoosain, Shenaaz Banoo Ghulam
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Abstract
Introduction: Diarrhoeal illness is a major contributor to morbidity and mortality in
children under five years. Hypernatraemia is a serious electrolyte disturbance associated
with diarrhoea. There is a paucity of data of the incidence and possible risk factors of
hypernatraemia in acute gastroenteritis amongst the paediatric population in South Africa.
Objective: To document the incidence of hypernatraemia in children admitted with
diarrhoea and any associations between hypernatraemia and potential risk factors.
Method: This study used a prospective cross - sectional convenience sample of children
between the ages of one and 24 months, who were admitted for diarrhoea complicated by
dehydration. Caregivers were interviewed and demographic, clinical and laboratory
variables were obtained.
Results: A total of a 125 children were included into the study. Fifty one of the 125
children (41%) had hypernatraemia. Their serum sodium levels ranged between 154 and
171 mmol/l. Age below one year (p< 0.001) and severe dehydration (p = 0.003) were risk
factors for hypernatraemia in the univariate analysis but only infancy remained significant
after the multivariate analysis (Odds ratio 10.6, 95% CI: 3.5 – 32.6, p<0.001). Three
patients demised and all were part of the hypernatraemic group (6% vs. 0%, p = 0.24).
Hypernatraemia was significantly associated with neurological deficits (14% vs. 0%, p =
0.013).
Conclusion: This study illustrated a high incidence of paediatric hypernatraemic
dehydration, which has not been reported in other studies. An age of less than one year old
was a statistically significant risk factor.
Description
A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand Johannesburg, in fulfillment of the requirements for the degree of Master of
Medicine in the branch of Paediatrics
Johannesburg, 2017