Hyponatremia in newborns
Last reviewed: 23.04.2024
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Hyponatremia is the concentration of sodium in serum less than 135 meq / l. Pronounced hyponatremia can lead to convulsions or coma. Treatment of hyponatremia - careful compensation of sodium 0.9% solution of sodium chloride; rarely requires a 3% solution of sodium chloride.
[What causes hyponatremia in newborns?
The most common cause of hyponatremia is hypovolemic dehydration in vomiting or diarrhea (or both) when large gastrointestinal losses are compensated for by a liquid in which there is little or no sodium.
Less common is euvolemic hyponatremia due to a violation of ADH secretion and, accordingly, fluid retention. Possible causes of violation of ADH secretion are infections and CNS tumors. Also, excessive dilution of infant formula can lead to water intoxication. Hypervolaemic hyponatremia develops in conditions of water retention and excessive sodium retention, for example, in cardiac and renal failure.
Symptoms of hyponatremia in newborns
Symptoms of hyponatremia include nausea and vomiting, apathy, headache, convulsions and coma; other symptoms include cramps and weakness. Newborns with hyponatremic dehydration may be in serious condition, as hyponatremia causes a disproportionate decrease in extracellular fluid. Syndromes and manifestations are associated with the duration and degree of hyponatremia.
Treatment of hyponatremia in newborns
Treatment of hyponatremia is carried out with 5% glucose solution, 0.45-0.9% sodium chloride solution intravenously in volumes corresponding to the calculated deficit administered for as many days as needed to correct the sodium concentration, but not more than 10-12 meq / ( l day) to avoid the rapid movement of fluid into the brain. Patients with hypovolemic hyponatraemia need to increase the volume of circulating blood using solutions containing salt to correct sodium deficiency (10-12 meq / kg body weight or even 15 meq / kg in young patients with severe hyponatremia) and maintain sodium requirements [ 3 meq / (kg day) in a 5% glucose solution]. Patients with symptoms of hyponatremia (eg, retardation, impaired consciousness) require emergency treatment with a 3% solution of sodium chloride to prevent seizures or coma.