View Contents. Hiponatremia, h.. BIBLIOGRAFÍA. Hiponatremia, hipernatremia y mortalidad en pacientes con nefropatía crónica. Mary E. Choi; Joseph Loscalzo. farsightedness, long-sightedness, hyperopia CD hipermetropía f hipernatremia f hypacusis CE) hipoacusia f hipocapnia f hypocapnia CD hipo- capnia f hipocinesia f ® hypokinesia CE) hi- + m) hipocrómico E«> hypochromic CE) . Hiponatremia e hipernatremia. Jose Miguel Castellón. Hiponatremia hipernatremia. fernandomolinalino. Fisiopatologia trastornos del Sodio.
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There were no deaths among the patients in our sample. Two of the newborns were delivered by caesarean section, one due to nonreassuring foetal hipernatremua rate tracings and the other due to prolonged labour.
In our sample, all cases had onset within 15 days from hio, with a median age at admission that was slightly greater compared to the age reported in other case series, which can probably be explained by our study focusing on newborns admitted after discharge from the maternity ward.
Twenty met the inclusion criteria. The most common reasons care was sought in our case series were, with equal frequency, irritability and jaundice, presenting symptoms that were consistent with the literature, which also describes presentations with hypertonia and hyperreflexia, altered level of consciousness or seizures, which were not observed in any of our patients 14, The scheduling of a first appointment at the hipernatremla of the first week of life could help prevent HND associated with BF or at least reduce its incidence, and also support BF, preventing early discontinuation of BF due to inefficient technique or maternal discouragement We excluded patients born preterm, with concomitant infectious disease, with underlying disease or who died of unknown causes during the study.
Out of the 22 NBs discharged with a diagnostic code of hypernatremic dehydration, 20 met the criteria for inclusion and 2 were excluded due to evidence of a triggering disease thrombophilia, urinary tract infection [UTI] The mean incidence during the year under study was 0. In our well-child programme, the first check-up visit is scheduled at 15 days post birth, which in our opinion is too late to detect problems derived from inadequate BF in at-risk NBs, as our data imply.
As reference for Spain, the incidence of hypernatremia per live births found in a study in Asturias was 0. We were able to conduct the study thanks to the standardisation of our electronic health records. There are few studies on its incidence in Spain. The overall frequency of HND in our sample 0. We found an association with exclusive breastfeeding, primiparity and greater maternal age.
It is a potentially severe condition 1,3 that can cause significant neurologic sequelae and even death 4.
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Severe neonatal hypernatremic dehydratation in the initiation of the breastfeeding: The median age at admission was 5. None of the patients died or had severe complications. The medium serum creatine level in our gipernatremia was 0. The median percentage of weight loss relative to the birth weight was The hipernateemia comorbidities found in our study were similar to those described in other studies in Spain, with mild acidosis detected in half of our sample, although our patients did not develop the disorders described in other case series while they received hipk to correct the acidosis 21, One of the limitations of our study, which was due to its retrospective design, was that we were unable to obtain data on parental educational attainment.
The most frequent reasons for seeking care were weight loss, jaundice and irritability. We estimated the size of the susceptible population during the period under study hi;o 41 newborns, which corresponded to the newborns delivered in the maternity departments of one secondary level hospital and one tertiary level hospital that are both part of the public health system in the catchment area of our sample.
RESULTS We estimated the size of the susceptible population during the period under study at 41 newborns, which corresponded to the newborns delivered in the maternity hlpernatremia of one secondary level hospital and one tertiary level hospital that are both part of the public health system in the catchment area of our sample.
The primary variable under study was the serum sodium level measured in a venous blood sample. Its onset typically occurs at about 8 days post birth, varying between 2 and 14 days depending on the study.
In most cases, the presenting complaints were problems associated with BF with signs that were easily identified in a basic physical examination. Furthermore, the baby may show signs of dehydration such as dry mucous membranes, a sunken fontanel, poor skin turgora malnourished appearance, jaundice, fever, oliguria or anuria or neurologic abnormalities.
Table 1 summarises the demographic and clinical characteristic of the newborns and their mothers. We compared differences in the incidence between the warm seasons spring and summer and gipernatremia cold seasons autumn and winter by means of the Student t test. Hypernatremic dehydration HND in exclusively breastfed newborns NBs is a health problem that started being featured in the literature in the s.
Contrary to other hiperbatremia, we did not find an association with caesarean delivery, as in Spain hipernahremia intervention usually does not entail a delay of more than 12 hours in BF initiation The median serum sodium level was We used the recorded population for our catchment area as the susceptible population for the purpose of calculating the incidence of HND.
Some authors have found an association between HND and high sodium concentrations in the breast milk of mothers that have difficulty BF, with absence of the physiological reduction in the concentration of this electrolyte 2, We excluded patients with underlying conditions or concomitant infection.
We performed the statistical analysis defining significance as a p -value of less than 0. Most mothers in our sample were primiparous, and the median maternal age was 34 years, which was consistent hiernatremia previous studies where the median ages of the mothers age were 30 17 and 34 years, Our study is the first in Spain to calculate the incidence of HND in newborns after discharge, identifying primiparity as a relevant maternal risk factor.
The mean uipernatremia age at birth was As occurred in previously published case series, excessive weight hieprnatremia from birth was a frequent hipernqtremia, as was the appearance of urate crystals in the urine 14, We retrieved the data from the health records of NBs admitted to our hospital. Education of health care staff though the development of consensus documents and the implementation of BF support workshops for mothers are measures that succeeded in reducing the incidence of HND in other facilities in Spain 13, We also categorised the reason parents sought care in our hospital based on the presenting symptoms: This condition is underdiagnosed, as it presents with nonspecific symptoms such as lethargy, although some patients become irritable instead.
Meaning of “hiponatremia” in the Portuguese dictionary
The authors have no conflicts of interest to declare in relation to the preparation and publication of this article. We believe hiprenatremia BF provides the best nutrition for the infant, but that it requires adequate monitoring, as having the first routine child wellness checkup early on, at day 7 post birth, could help reduce the incidence of lactation failure and HND.
Reference of this article.: The mean length of stay was 6.