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Pediatric electrolytes

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By Terren Trott
John R Montford, Stuart Linas
Hyperkalemia is a potentially life-threatening electrolyte disorder appreciated with greater frequency in patients with renal disease, heart failure, and with use of certain medications such as renin angiotensin aldosterone inhibitors. The traditional views that hyperkalemia can be reliably diagnosed by electrocardiogram and that particular levels of hyperkalemia confer cardiotoxic risk have been challenged by several reports of patients with atypic presentations. Epidemiologic data demonstrate strong associations of morbidity and mortality in patients with hyperkalemia but these associations appear disconnected in certain patient populations and in differing clinical presentations...
November 2017: Journal of the American Society of Nephrology: JASN
Dan A Henry
No abstract text is available yet for this article.
August 4, 2015: Annals of Internal Medicine
R Shroff, R Hignett, C Pierce, S Marks, W van't Hoff
We describe five babies, who were exclusively breast fed, with life-threatening complications of hypernatraemic dehydration secondary to inadequate breast feeding. An increased awareness among health professionals is required so that this potentially devastating condition can be prevented.
December 2006: Archives of Disease in Childhood
Gabriel Konetzny, Hans Ulrich Bucher, Romaine Arlettaz
UNLABELLED: Hypernatraemic dehydration, which predominantly appears in breastfed neonates, can cause serious complications, such as convulsions, permanent brain damage and death, if recognised late. Weight loss > or = 10% of birth weight could be an early indicator for this condition. In this prospective cohort study from October 2003 to June 2005 in the postnatal ward of the University Hospital Zurich, Switzerland, all term newborns with birth weight > or = 2,500 g were weighed daily until discharge...
July 2009: European Journal of Pediatrics
Maura A Watson, Thomas P Baker, Annie Nguyen, Mary E Sebastianelli, Heather L Stewart, David K Oliver, Kevin C Abbott, Christina M Yuan
BACKGROUND: Colonic necrosis has been reported after sodium polystyrene sulfonate (SPS)/sorbitol use, but the incidence and relative risk (RR) are not established. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: 123,391 adult inpatients at a tertiary medical center. PREDICTOR: Receipt of SPS prescriptions (exposed) or a prescription other than SPS (unexposed internal comparison group) between September 1, 2001, and October 31, 2010...
September 2012: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Elwaleed A Elhassan, Robert W Schrier
PURPOSE OF REVIEW: Recent studies have consistently demonstrated the common prevalence of hyponatremia in the hospital and intensive care settings, and how it correlates with untoward outcomes. This review discusses the classification, diagnosis, and pathophysiology of hyponatremia and how these agents may influence its management, and also examines the available treatment options and their weaknesses and strengths. RECENT FINDINGS: This review is timely and relevant, as mild degrees of serum sodium lowering may be associated with adverse neurologic and musculoskeletal effects...
March 2011: Current Opinion in Nephrology and Hypertension
H J Adrogué, N E Madias
No abstract text is available yet for this article.
May 25, 2000: New England Journal of Medicine
Ruediger W Lehrich, David I Ortiz-Melo, Mehul B Patel, Arthur Greenberg
Hyponatremia, the most commonly encountered electrolyte abnormality, affects as many as 30% of hospitalized patients. It is a powerful predictor of poor outcomes, especially in patients with congestive heart failure or cirrhosis. The failure to excrete electrolyte-free water that results from persistent secretion of antidiuretic hormone despite low serum osmolality usually underlies the development of hyponatremia. Treatment depends on several factors, including the cause, overall volume status of the patient, severity of hyponatremic symptoms, and duration of hyponatremia at presentation...
August 2013: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Walter A Parham, Ali A Mehdirad, Kurt M Biermann, Carey S Fredman
Hyperkalemia is a common clinical condition that can induce deadly cardiac arrhythmias. Electrocardiographic manifestations of hyperkalemia vary from the classic sine-wave rhythm, which occurs in severe hyperkalemia, to nonspecific repolarization abnormalities seen with mild elevations of serum potassium. We present a case of hyperkalemia, initially diagnosed as ventricular tachycardia, to demonstrate how difficult hyperkalemia can be to diagnose. An in-depth review of hyperkalemia is presented, examining the electrophysiologic and electrocardiographic changes that occur as serum potassium levels increase...
2006: Texas Heart Institute Journal
Kavitha Masilamani, Judith van der Voort
This review article describes the pathophysiology and common aetiologies of hyperkalaemia including pseudohyperkalaemia, renal impairment, medication, rhabdomyolysis and aldosterone deficiency. Two clinical cases are used to describe symptoms (mainly muscle weakness and arrhythmias) and illustrate different management options. An approach to management including relevant investigations and interpretation of ECG changes is described. Emergency drug treatments are outlined and the effectiveness of individual therapeutic methods in reducing the potassium concentration described...
April 2012: Archives of Disease in Childhood
Kathryn E Roberts
The care of the critically ill infant or child often is complicated further by disruptions in fluid or electrolyte balance. Prompt recognition of these disruptions is essential to the care of these patients. This article provides an overview of the principles of fluid and electrolyte balance in the critically ill infant and child. Imbalances in fluid homeostasis and imbalances in sodium, potassium, and calcium homeostasis are presented in a case study format.
December 2005: Critical Care Nursing Clinics of North America
M Jose Rodríguez, Andrés Alcaraz, Maria Jose Solana, Ana García
AIM: To review the incidence of hyponatraemic encephalopathy in children treated in a tertiary care centre hospital, together with the clinical setting and clinical management of these cases. METHODS: Retrospective descriptive study by chart review of patients admitted to hospital during 2000-2010. Patients older than 1 month were included who had severe hyponatraemia (sodium concentration <125 mmol/L) on admission or during their hospital stay and co-incidental neurological symptoms...
January 2014: Acta Paediatrica
Grischa Marti, Christoph Schwarz, Alexander B Leichtle, Georg-Martin Fiedler, Spyridon Arampatzis, Aristomenis K Exadaktylos, Gregor Lindner
OBJECTIVES: To investigate the prevalence, etiology, and symptoms of severe hypokalemia in patients presenting to the emergency department. METHODS: In this retrospective, cross-sectional analysis, we included all patients who received measurement of serum potassium between April 2008 and 31 March 2011 at the emergency department to calculate the prevalence rate for hypokalemia. Of all patients with a serum potassium below 2.6 mmol/l (severe hypokalemia), we performed a detailed review of the patients' charts from the emergency department and the chart of the subsequent hospitalization...
February 2014: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Brian M Cummings, Eric A Macklin, Phoebe H Yager, Amita Sharma, Natan Noviski
BACKGROUND: Potassium abnormalities are common in critically ill patients. We describe the spectrum of potassium abnormalities in our tertiary-level pediatric intensive care unit (PICU). METHODS: Retrospective observational cohort of all the patients admitted to a single-center tertiary PICU over a 1-year period. Medical records and laboratory results were obtained through a central electronic data repository. RESULTS: A total of 512 patients had a potassium measurement...
September 2014: Journal of Intensive Care Medicine
Timothy E Brenkert, Cristina M Estrada, Sheila P McMorrow, Thomas J Abramo
OBJECTIVES: The objective of this study was to describe the use, dosing, and administration of intravenous hypertonic saline (IHS) use in a pediatric emergency department. METHODS: This was a retrospective chart review of patients 0 to 18 years receiving IHS as part of their management in a pediatric ED with an annual volume of more than 50,000 visits. RESULTS: Over 4 years, 56 patients received IHS as part of their management in the emergency department...
January 2013: Pediatric Emergency Care
Mohammed A El-Bayoumi, Alaa M Abdelkader, Mohamed M A El-Assmy, Angi A Alwakeel, Hanem M El-Tahan
UNLABELLED: To demonstrate safety and efficacy of using normal saline (NS) for initial volume expansion (IVE) and rehydration in children with diarrhea-related hypernatremic dehydration (DR-HD), forty eight patients with DR-HD were retrospectively studied. NS was used as needed for IVE and for initial rehydration. Fluid deficit was given over 48 h. Median Na(+) level on admission was 162.9 mEq/L (IQR 160.8-165.8). The median average hourly drop at 6 and 24 h was 0.53 mEq/L/h (0.48-0.59) and 0...
February 2012: European Journal of Pediatrics
Steven A Lietman, Emily L Germain-Lee, Michael A Levine
PURPOSE OF REVIEW: In this review, we define hypercalcemia levels, common causes for hypercalcemia in children, and treatment in order to aid the practicing pediatrician. RECENT FINDINGS: One rare cause of hypercalcemia in the child is familial hypocalciuric hypercalcemia (also termed familial benign hypercalcemia). Mutations that inactivate the Ca-sensing receptor gene FHH have been described as an autosomal dominant disorder, but recently milder mutations in the CASR have been shown to cause hypercalcemia when homozygous...
August 2010: Current Opinion in Pediatrics
Rodo O von Vigier, Maria Teresa Ortisi, Angela La Manna, Mario G Bianchetti, Alberto Bettinelli
Hypokalemia is a recognized cause of rhabdomyolysis but very few reports document its association with inborn renal tubular disorders. We report our experience with hypokalemic rhabdomyolysis in 5 pediatric patients affected by inborn renal tubular disorders and the results of a careful review of the literature disclosing 9 further cases for a total of 14 patients (8 male and 6 female subjects, aged between 1.6 and 46, median 16 years). The inborn renal tubular disorders underlying rhabdomyolysis were classic distal renal tubular acidosis (n = 7), Gitelman syndrome (n = 5), classic Bartter syndrome (n = 1), and antenatal Bartter syndrome (n = 1)...
May 2010: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Anwarul Haque, Ali Faisal Saleem
OBJECTIVE: To determine the frequency and associated risk factors of hypomagnesemia in pediatric intensive care unit on admission in a developing country. METHODS: It is a retrospective chart review of 179 children aged 1 mo - 15yr admitted in Pediatric Intensive Care Unit of our university during 18 months and recorded serum Mg level on admission. Patients were divided into two groups according to their Mg level (Normo-magnesemic and Hypomagnesemic) and their p-value, crude and adjusted odds ratios (AoR) were calculated...
December 2009: Indian Journal of Pediatrics
Michael L Moritz, Juan Carlos Ayus
Hyponatremia is the most common electrolyte abnormality encountered in children. In the past decade, new advances have been made in understanding the pathogenesis of hyponatremic encephalopathy and in its prevention and treatment. Recent data have determined that hyponatremia is a more serious condition than previously believed. It is a major comorbidity factor for a variety of illnesses, and subtle neurological findings are common. It has now become apparent that the majority of hospital-acquired hyponatremia in children is iatrogenic and due in large part to the administration of hypotonic fluids to patients with elevated arginine vasopressin levels...
July 2010: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
2015-03-16 16:58:41
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