Clinical Pediatric Emergency Medicine
Volume 10, Issue 4 , Pages 272-278 , December 2009

Hypernatremia and Hyponatremia: Current Understanding and Management

  • Catherine H. Chung, MD, MPH

      Affiliations

    • Corresponding Author InformationReprint requests and correspondence: Catherine H. Chung, MD, MPH, Division of Emergency Medicine, Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL 60614.
    • Division of Emergency Medicine, Children's Memorial Hospital, Chicago, IL
    • ,
  • Donald Zimmerman, MD

      Affiliations

    • Division of Endocrinology, Children’s Memorial Hospital, Chicago, IL

References 

  1. Fleisher G, Ludwig S. Textbook of pediatric emergency medicine. 4th ed. Philadelphia (Pa): Lippincott Williams and Wilkins; 2000;
  2. Moritz M, Manole M. Breastfeeding-associated hypernatremia: are we missing the diagnosis?. Pediatrics. 2005;116:e343–e347
  3. Unal S, Arhan E. Breast-feeding-associated hypernatremia: retrospective analysis of 169 term newborns. Pediatr Int. 2008;50:29–34
  4. Leung C, Chang WC. Hypernatremic dehydration due to concentrated infant formula: report of two cases. Pediatr Neonatol. 2009;50:70–73
  5. Van Amerongen RH, Moretta AC. Severe hypernatremic dehydration and death in a breast-fed infant. Pediatr Emerg Care. 2001;17:175–180
  6. Moritz M, Ayus J. Changing pattern of hypernatremia in hospitalized children. Pediatrics. 1999;104:435–439
  7. Robertson G, Carrhill M. Relationship between fluid management, changes in serum sodium and outcome in hypernatremia associated with gastroenteritis. Paediatr Child Health. 2007;43:291–296
  8. Josepe N, Forbes G. Fluid and electrolytes—clinical aspects. Pediatr Rev. 1996;17:395–403
  9. Moritz M, Ayus J. Disorders of water metabolism in children: hyponatremia and hypernatremia. Pediatr Rev. 2002;23:371–380
  10. Moritz M, Ayus J. Preventing neurological complications from dysnatremias in children. Pediatr Nephrol. 2005;20:1687–1700
  11. Roberts K. Fluid and electrolytes: parenteral fluid therapy. Pediatr Rev. 2002;22:380–387
  12. Farrer HC, Chande VT. Hyponatermia as the cause of seizures in infants: retrospective analysis of incidence, severity and clinical predictors. Ann Emerg Med. 1995;26:42–48
  13. Lin CY, Tsau YK. Child abuse: acute water intoxication in a hyperactive child. Acta Paediatr Taiwan. 2005;46:39–41
  14. Tilelli JA, Ophoven JP. Hyponatremic seizures as a presenting symptom of child abuse. Forensic Sci Int. 1986;2-3:213–217
  15. Arieff AI, Kronlund BA. Fatal child abuse by forced water intoxication. Pediatrics. 1999;103(6 Pt 1):1292–1295
  16. Bruce RC, Kliegman RM. Hyponatremic seizures secondary to oral water intoxication in infancy: association with commercial bottled drinking water. Pediatrics. 1997;100:E4
  17. Hoorn E, Geary D. Acute hyponatremia related to intravenous fluid administration in hospitalized children: an observational study. Pediatrics. 2004;113:1279–1284
  18. Au A, Ray P. Incidence of postoperative hyponatremia and complications in critically-ill children treated with hypotonic and normotonic solutions. J Pediatr. 2008;152:33–38
  19. Moritz M, Ayus J. Hospital acquired hyponatremia—why are hypotonic parenteral fluid still being used?. Nephrology. 2007;3:374–382
  20. Ray P. Neurological complications from dysnatremias in children: a different point of view. Pediatr Nephrol. 2006;21:1048–1049
  21. Choong K, Kho ME. Hypotonic versus isotonic saline in hospitalized children: a systematic review. Arch Dis Child. 2006;91:828–835[Epub 2006 Jun 5]
  22. Yung M, Keely S. Randomised controlled trial of intravenous maintenance fluids. J Paediatr Child Health. 2009;45:9–14[Epub 2007 Nov]
  23. Jackson J. Risks of Intravenous administration of hypotonic fluids for pediatric patients in ED and prehospital settings: let's remove the handle from the pump. Am J Emerg Med. 2000;18:269–270

PII: S1522-8401(09)00095-0

doi: 10.1016/j.cpem.2009.11.002

Clinical Pediatric Emergency Medicine
Volume 10, Issue 4 , Pages 272-278 , December 2009

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