DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20190227

Clinical profile of neonates admitted with hypernatremia in NICU at tertiary hospital in Vadodara, Gujarat, India

Nimisha Pandya, Kedar G. Mehta

Abstract


Background: Neonatal hypernatremia is less common but significant  metabolic problem  with acute morbidity as well as long term consequences. Many causative  factors have been identified such  as inadequate breastfeeding, hot  weather with high  evaporative losses ,  infections etc. It is important to identify, anticipate and correct the condition before it leads to damaging consequences. The objective of the present study was evaluation of clinical profile, renal parameters and causative factors associated with hypernatremia in exclusively breast-fed infants.

Methods: A retrospective review of  30 new-borns less than 28 days of age admitted in  GMERS General hospital for hypernatremia was conducted. The study group included inborn and out born admissions. Records were reviewed, feeding history, severity of hypernatremia and altered renal parameters were analysed. The study period was from April 2018to June2018i.e summer months.

Results: Total NICU admissions were 303 during these months  out of which 30 were diagnosed  with hypernatremia completely and discharged. Mean age of presentation was 8.4 days. Sodium levels ranged from 146-179 mmol/l. Mild hypernatremia was most common (56.7%), followed by moderate hypernatremia in 40%. All neonates were on  exclusive breast feeding. Majority of the affected neonates were term SGA followed by term AGA and preterm AGA. Renal parameters were altered in quarter of affected  infants.  Most common clinical feature noted was lethargy(70%), followed  by fever(53.3%),significant weight loss ,jaundice and dehydration. 29 patients were successfully discharged on breast milk feeding.

Conclusions: Hypernatremia though rare, is common in young infants in summer months. It is preventable and treatable condition. It is important to anticipate, identify and treat such patients at the earliest. Treating physicians and nursing staff should be more vigilant for establishment of breast feeding in low birth weight infants. Exclusive breast feeding for first six months of life should always be promoted.


Keywords


Dehydration, Exclusive breast feeding, Hypernatremia, Low birth weight

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