BibTex RIS Kaynak Göster

Hipernatremik Dehidratasyon Tanılı Yenidoğan Olgularımızın Değerlendirilmesi

Yıl 2013, Cilt: 7 Sayı: 3, 124 - 127, 01.10.2013

Öz

Amaç: Son zamanlarda sadece anne sütüyle beslenen yenidoğanlarda, yüksek morbidite ve mortaliteye neden olabilen hipernatremik dehidratasyon olgularında belirgin artış gözlenmektedir. Bu çalışmada hipernatremik dehidratasyonu olan yenidoğan bebeklerin demografik özelliklerini ve epidemiyolojik risk faktörlerini ortaya çıkarmak ve dehidratasyon olgularının sayısını azaltacak uygulamaları belirlemek amaçlanmıştır. Gereç ve Yöntemler: Çalışmamızda Ocak 2009- Haziran 2012 tarihleri arasında hastanemiz yenidoğan polikliniğine başvuran serum sodyum konsantrasyonu ≥150 mEq/L olan 87 term yenidoğan bebek geriye yönelik değerlendirildi Bulgular: Bebeklerin 49’u (%56) erkek, 38’i (%44) kız ve ortalama doğum ağırlıkları 3424±395 gram’dı. Olguların ortalama başvuru yaşları 4.3±2.8 gün ve ortalama kilo kayıpları %12.2±4.2 olarak bulundu. Normal spontan vajinal yol ile doğum ve primipar annelerin oranı sırası ile %51.7 ve % 75.8’di. Olguların %96.5’i sadece anne sütü ile beslenmişti. Bebeklerin en sık başvuru şikayetleri ateş (%24.7), sarılık (%23.5) ve zayıf emme (%10.6) iken %37.6’inde başvuru anında yakınma bulunmamaktaydı. Çalışmamız süresince bir hastada intrakranial, bir hastada ise ekstremitede tromboz tespit edildi. Başvuru sırasında ortalama serum sodyum, üre ve kreatinin düzeyleri sırası ile 155.2±6.2 mEq/L, 89.1±73.9 mg/ dl ve 0.89±0.65 mg/dl olarak tespit edildi. Hastaların %66.7’sine intravenöz mayi desteği verildi. Olguların hastanede yatış süresi ortalama 2.6±2.3 gündü. Sonuç: Emzirme yetersizliğine bağlı olarak gelişen hipernatremik dehidratasyon yenidoğan bebeklerde halen ciddi bir problem olarak görünmektedir. Yenidoğan bebeklerin hayatın ilk günlerinde rutin olarak değerlendirilmesi hipernatremik dehidratsyonun erken tanı ve tedavisi için önemlidir. Ateş, sarılık ve emmede zayıflık olan bebeklerde hipernatremikdehidratasyon düşünülmelidir. Ayrıca gerekli olgularda sodyum ölçümün yapılması yararlı olabilir.

Kaynakça

  • Hall RT, Simon S, Smith MT. Readmission of breast-fed infants in the first 2 weeks of life. J Perinatol 2000;20:432-37.
  • Neville M, Morton J. Physiology and endocrine changes underlying human lactogenesis II. J Nutrition 2001;131:3005-8.
  • 3. Vatansever U, Duran R, Acunas B. Tek başınna anne sütü ile beslenen bebeklerde hipernatremik dehidratasyon. Trakya Univ Tıp Fak Derg 2007;24:190-5.
  • 4. Molteni K H. Initial management of hypernatremic dehydration in the breastfed infant. Clin Pediatr 1994;33:731-40.
  • 5. Cağlar MK, Altugan FS, Ozer I. Exclusively breastfeeding and hypernatremic dehydration. Iranian J Publ Health 2005;34:1-11.
  • 6. Neiffert MR. Prevention of breastfeeding tragedies. Pediatr Clin North Am 2001;48:273-97.
  • 7. Modi N. Avoiding hypernatraemic dehydration in healthy term infants. Arch Dis Child 2007;92:474-5.
  • 8. Thullen JD. Management of hypernatremic dehydration due to insufficient lactation. Clin Pediatr 1988;27:370-72.
  • 9. Oddie S, Richmond S, Coulthard M. Hypernatremic dehydration and breast feeding. Arch Dis Child 2001;85:318-20.
  • 10. Heldrich FJ, Shaw SS. Case report and review of literature in breast fed infants. Maryland Med J 1990;39:475-78.
  • 11. Gartner LM, Morton J, Lawrence RA, Naylor AJ, O’Hare D, Schanler RJ, et al., American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2005;115:496-506.
  • 12. Caglar MK, Ozer I, Altugan FS. Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants. Braz J Med Biol Res 2006;39: 539-44.
  • 13. Uras N, Karadag A, Dogan G, Tonbul A, Tatli MM. Moderate hypernatremic dehydration in newborn infants: Retrospective evaluation of 64 cases. J Matern Fetal Neonatal Med 2007;20:4 49-52.
  • 14. Unal S, Arhan E, Kara N, Uncu N, Aliefendioğlu D. Breastfeedingassociated hypernatremia: Retrospective analysis of 169 term newborns. Pediatr Int 2008;50:29-34.
  • 15. Chapman DJ, Perez-Escamilla R. Maternal perception of the onset of lactation is a valid, public health indicator of lactogenesis stage II. J Nutrition 2000;130:2972-80.
  • 16. Arboit JM, Gildengers E. Breastfeeding and hypernatremia. J Pediatr 1980;97:335-6.
  • 17. Zachariassen G, Juvonen P. Neonatal dehydration (dehydration fever) in newborn infants. Ugeskr Laeger 2002;164:4930-4.
  • 18. Cooper WO, Atherton HD, Kahana M, Kotagal UR. Increased incidence of severe breastfeeding malnutrition and hypernatremia in a metropolitan area. Pediatrics 1995;96:957-60.
  • 19. Iglesias Fernández C, Chimenti Camacho P, Vázquez López P, Guerrero Soler M, Blanco Bravo D. Aortic and cerebral trombosis caused by hypernatremic dehydration in an exclusively breast-fed infant. An Pediatr 2006;65:381-3.
  • 20. Gebara BM, Everett KO. Dural sinus thrombosis complicating hypernatremic dehydration in a breastfed neonate. Clin Pediatr 2001;40:45-8.

The Evaluation of Neonatal Cases with Hypernatremic Dehydration

Yıl 2013, Cilt: 7 Sayı: 3, 124 - 127, 01.10.2013

Öz

Objective: The incidence of hypernatremic dehydration because of the lactation failure in newborns, causing higher rates of morbidity and mortality, has increased in recent years. The aim of the study was to identify the preventive approaches for hypernatremic dehydration by determining demographic characteristics and epidemiologic risk factors in newborns with hypernatremic dehydration.Material and Methods: A total of 87 term neonates with a serum sodium level ≥150 mEq/L that presented at our clinic between January 2009 and June 2012 were evaluated retrospectively.Results: There were 49 (56%) male and 38 (44%) female infants. Mean birth weight was 3424±395 grams. Mean age and mean percentage of weight loss at admission were 4.3±2.8 days and 12.2±4.2 % respectively. The percentages of spontaneous vaginal delivery and primiparous mothers were 51.7% and 75.8% respectively. Breast milk had been used exclusively in 97%. The most common complaints were fever (24.7%), jaundice (23.5%), and poor absorption (10.6%), while 37.6% did not have symptoms at the time of hospital admission. One infant received a diagnosis of intracranial venous thrombosis and another infant lower extremity venous thrombosis over the study period. The mean sodium, urea and creatinine levels at admission were 155.2±6.2 mEq/L, 89.1±73.9 mg/dl and 0.89±0.65 mg/dl respectively. Intravenous fluid resuscitation was required in 67% of the infants. Mean duration of hospitalization was 2.6±2.3 days.Conclusion: Hypernatremic dehydration from lactation failure remains a serious problem in newborns. Routine newborn examination in the first few days of life is important for the early diagnosis and prevention of this condition. Hypernatremic dehydration should be considered in infants with fever, jaundice and poor sucking. Moreover, determination of the Na level should be helpful when required

Kaynakça

  • Hall RT, Simon S, Smith MT. Readmission of breast-fed infants in the first 2 weeks of life. J Perinatol 2000;20:432-37.
  • Neville M, Morton J. Physiology and endocrine changes underlying human lactogenesis II. J Nutrition 2001;131:3005-8.
  • 3. Vatansever U, Duran R, Acunas B. Tek başınna anne sütü ile beslenen bebeklerde hipernatremik dehidratasyon. Trakya Univ Tıp Fak Derg 2007;24:190-5.
  • 4. Molteni K H. Initial management of hypernatremic dehydration in the breastfed infant. Clin Pediatr 1994;33:731-40.
  • 5. Cağlar MK, Altugan FS, Ozer I. Exclusively breastfeeding and hypernatremic dehydration. Iranian J Publ Health 2005;34:1-11.
  • 6. Neiffert MR. Prevention of breastfeeding tragedies. Pediatr Clin North Am 2001;48:273-97.
  • 7. Modi N. Avoiding hypernatraemic dehydration in healthy term infants. Arch Dis Child 2007;92:474-5.
  • 8. Thullen JD. Management of hypernatremic dehydration due to insufficient lactation. Clin Pediatr 1988;27:370-72.
  • 9. Oddie S, Richmond S, Coulthard M. Hypernatremic dehydration and breast feeding. Arch Dis Child 2001;85:318-20.
  • 10. Heldrich FJ, Shaw SS. Case report and review of literature in breast fed infants. Maryland Med J 1990;39:475-78.
  • 11. Gartner LM, Morton J, Lawrence RA, Naylor AJ, O’Hare D, Schanler RJ, et al., American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2005;115:496-506.
  • 12. Caglar MK, Ozer I, Altugan FS. Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants. Braz J Med Biol Res 2006;39: 539-44.
  • 13. Uras N, Karadag A, Dogan G, Tonbul A, Tatli MM. Moderate hypernatremic dehydration in newborn infants: Retrospective evaluation of 64 cases. J Matern Fetal Neonatal Med 2007;20:4 49-52.
  • 14. Unal S, Arhan E, Kara N, Uncu N, Aliefendioğlu D. Breastfeedingassociated hypernatremia: Retrospective analysis of 169 term newborns. Pediatr Int 2008;50:29-34.
  • 15. Chapman DJ, Perez-Escamilla R. Maternal perception of the onset of lactation is a valid, public health indicator of lactogenesis stage II. J Nutrition 2000;130:2972-80.
  • 16. Arboit JM, Gildengers E. Breastfeeding and hypernatremia. J Pediatr 1980;97:335-6.
  • 17. Zachariassen G, Juvonen P. Neonatal dehydration (dehydration fever) in newborn infants. Ugeskr Laeger 2002;164:4930-4.
  • 18. Cooper WO, Atherton HD, Kahana M, Kotagal UR. Increased incidence of severe breastfeeding malnutrition and hypernatremia in a metropolitan area. Pediatrics 1995;96:957-60.
  • 19. Iglesias Fernández C, Chimenti Camacho P, Vázquez López P, Guerrero Soler M, Blanco Bravo D. Aortic and cerebral trombosis caused by hypernatremic dehydration in an exclusively breast-fed infant. An Pediatr 2006;65:381-3.
  • 20. Gebara BM, Everett KO. Dural sinus thrombosis complicating hypernatremic dehydration in a breastfed neonate. Clin Pediatr 2001;40:45-8.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Diğer ID JA35MF89HZ
Bölüm Research Article
Yazarlar

Nilüfer Güzoğlu Bu kişi benim

Avidan Kızılelma Bu kişi benim

Fatma Nur Sarı Bu kişi benim

Nurdan Uraş Bu kişi benim

Uğur Dilmen Bu kişi benim

Yayımlanma Tarihi 1 Ekim 2013
Gönderilme Tarihi 1 Ekim 2013
Yayımlandığı Sayı Yıl 2013 Cilt: 7 Sayı: 3

Kaynak Göster

Vancouver Güzoğlu N, Kızılelma A, Sarı FN, Uraş N, Dilmen U. The Evaluation of Neonatal Cases with Hypernatremic Dehydration. Türkiye Çocuk Hast Derg. 2013;7(3):124-7.

13548  21005     13550