Study finds, Serum Sodium and Clinical Outcome in Pediatric
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Researchers aimed to study the serum sodium level and clinical outcome in pediatric nontraumatic coma.

A prospective cohort study was conducted in a tertiary care pediatric intensive care unit (PICU). Children aged less than 13 y with nontraumatic coma were included. Children who received intravenous fluids for more than 24 h, those with developmental delay, or died within 24 h of admission were excluded. The serum sodium profile (mEq/L) in the first 72 h and clinical outcome [mortality, length of stay in mechanical ventilation, PICU, and hospital] were studied.

Results:
--80 patients [Died n=26 and Survived n=54] were enrolled. Median [interquartile range (IQR)] age and m-GCS were 21 mo and 9, respectively.

--The mean Pediatric Risk of Mortality-III (PRISM-III) was 17.7. The most common etiology was acute central nervous system infections (30%, n=24) followed by an intracranial bleed (11.3%, n=9).

--Mean sodium levels and fluctuation of serum sodium from baseline up to 72 h were similar between nonsurvivors and survivors [140.8 vs. 139.6] and [1.2 vs. 0.8], respectively.

--On multivariate analysis, the need for vasoactive therapy was an independent predictor of mortality [adjusted odds ratio=20.78].

In conclusion, a normal range of serum sodium and a fluctuation of 0.8 to 1.2 mEq/L in serum sodium over 72 hours were not associated with poor outcomes in pediatric nontraumatic coma. Vasoactive therapy was found to be a reliable predictor of death.

Source: https://link.springer.com/article/10.1007/s12098-021-03726-4
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