A hyponatremia is present at a serum sodium concentration of <135 mEq / L. A pronounced hyponatremia can cause seizures or loss of consciousness. The treatment consists in a prudent sodium exchange with i.v. 0.9% saline solution, in rare cases, a 3% saline solution is needed, particularly when seizures occur.

A hyponatremia is present at a serum sodium concentration of <135 mEq / L. A pronounced hyponatremia can cause seizures or loss of consciousness. The treatment consists in a prudent sodium exchange with i.v. 0.9% saline solution, in rare cases, a 3% saline solution is needed, particularly when seizures occur.

(Hyponatremia in adults is treated elsewhere). A hyponatremia is present at a serum sodium concentration of <135 mEq / L. A pronounced hyponatremia can cause seizures or loss of consciousness. The treatment consists in a prudent sodium exchange with i.v. 0.9% saline solution, in rare cases, a 3% saline solution is needed, particularly when seizures occur. Etiology The most common cause of neonatal hyponatremia is the hypovolemic dehydration from vomiting, diarrhea, or both, when large gastrointestinal losses caused by fluids with little or no sodium content are replaced (eg. As some juices). A less common cause is the euvolämische dehydration by an inadequate ADH secretion and consequent water retention. Possible causes of inadequate water retention are CNS tumors and infections. In addition, an excessive dilution of infant formula can lead to water intoxication. Finally, a hypervolaemic hyponatremia with water and marked sodium retention is seen as part of a cardiac or renal insufficiency. Symptoms Typical symptoms of hyponatremia in newborns include nausea, vomiting, apathy, headache, seizures, hypothermia and loss of consciousness; also can cause muscle cramps and weakness. Infants with a hyponatraemic dehydration can act very ill, as the hyponatremia causes a disproportionate reduction in the extracellular fluid volume. The symptoms depend on the duration and the extent of hyponatremia. Diagnostic serum sodium concentration due to the symptoms, the diagnosis of hyponatremia may be suspected in newborns and confirmed by the determination of the serum sodium concentration. As part of dehydration can also lead to an increase in urea concentration. Treatment 5% D / W / 0.45% to 0.9% sodium chloride solution i.v. Rarely hypertonic (3%) saline i.v. The treatment of neonatal hyponatremia is carried out by infusion of 5% dextrose with 0.45 to 0.9% saline solution; the infusion quantity is determined by the calculated volume deficiency. To avoid too rapid a shift in volumes in the brain, the infusion rate should be chosen over several days so that the sodium concentration is corrected by more than 10 to 12 mEq / day. Newborns with hypovolemic hyponatremia require fluid resuscitation with a saline infusion to balance the sodium deficit (10-12 mEq / kg of body weight or even 15 mEq / kg in young infants with severe hyponatremia), and in addition the basic demand for sodium (3 mEq / kg in 5% D / W solution). Neonates with symptomatic hyponatremia (z. B. with lethargy, confusion) emergency basis with 3% salt solution must i.v. be treated to prevent convulsions or coma Clinical calculator: rate of the infusate for correcting hyponatremia Clinical calculator: sodium deficit hyponatremia

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