| Fluid management of hypernatraemic dehydration to prevent cerebral oedema: a retrospective case control study of 97 children in China. | |
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MedLine Citation:
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PMID: 20412412 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To compare the fluid management of hypernatraemic dehydration in acute gastroenteritis in those who developed cerebral oedema (cases) versus those who did not (controls). METHODS: A retrospective study of 97 cases of hypernatraemic dehydration at a tertiary children's hospital in China over five years, in which rehydration regimes of 49 children who developed cerebral oedema were compared with 48 children who made an uneventful recovery. RESULTS: Risk factors for cerebral oedema (vs. no cerebral oedema) were an initial fluid bolus (29/49 vs. 15/48, P=0.006), the mean rate of bolus infusion (14.7+/-2.2 vs. 10.8+/-1.4 mL/kg/hr, P<0.001), the severity of hypernatraemia (serum sodium 167.7+/-7.8 vs. 161.3+/-7.9 mmol/L, P<0.001) and the overall rehydration rate (8.2+/-1.1 vs. 6.4+/-0.6 mL/kg/hr, P<0.001). On logistic regression, a rapid rehydration rate was the most significant contributor to cerebral oedema. From receive operating characteristic (ROC) curve analysis, the safe rate of rehydration was <6.8 mL/kg/hr. CONCLUSION: The key risk factors for the development of cerebral oedema during recovery from hypernatraemic dehydration were too rapid a rate of rehydration, an initial fluid bolus to rapidly expand plasma volume and the severity of the hypernatraemia. Thus, we conclude that a uniformly slow rate of rehydration is the best way of preventing cerebral oedema. |
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Authors:
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Chengqing Fang; Jianhua Mao; Yuwen Dai; Yonghui Xia; Haidong Fu; Yifang Chen; Yaping Wang; Aimin Liu |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-04-16 |
Journal Detail:
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Title: Journal of paediatrics and child health Volume: 46 ISSN: 1440-1754 ISO Abbreviation: J Paediatr Child Health Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-07-20 Completed Date: 2010-12-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9005421 Medline TA: J Paediatr Child Health Country: Australia |
Other Details:
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Languages: eng Pagination: 301-3 Citation Subset: IM |
Affiliation:
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Department of Nephrology, The Children's Hospital of Zhejiang University School of Medicine, Hang Zhou, China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Brain Edema / etiology, prevention & control* Case-Control Studies China Dehydration / physiopathology*, therapy* Fluid Therapy* Gastroenteritis Humans Hypernatremia / physiopathology*, therapy* Infant Male Retrospective Studies Treatment Outcome |
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