VIEW
SHAREOverview
Sodium abnormalities in the form of hyponatremia and hypernatremia are common in sick children, and can result in seizures, cerebral edema and death. The key management issues are to begin IV fluids as isotonic saline, at a rate determined by the volume status – fluid restrict if hypervolemic (most commonly in hyponatremia), and rehydrate if dehydrated (most common in hypernatremia), and to carefully limit the rate of sodium correction.
Most Recent References
Osmotic Demyelination Syndrome in Children. Bansal LR, Zinkus T. Pediatr Neurol. 2019 Mar 28.
Clinical Practice Guideline: Maintenance Intravenous Fluids in Children. Feld LG, Neuspiel DR, Foster BA, Leu MG, Garber MD, Austin K, Basu RK, Conway EE Jr, Fehr JJ, Hawkins C, Kaplan RL, Rowe EV, Waseem M, Moritz ML; Subcommittee on Fluid and Electrolyte Therapy. Pediatrics. 2018 Dec;142(6).
Normal Correction of Sodium Leading to Central Pontine Demyelinosis: A Rare Occurrence. Siddiqui FS, Javed Z, Mahmood U, Saeed I, Qasim YF, Saeed MSB. Cureus. 2018 Sep 4;10(9):e3252