High antidiuretic hormone levels and hyponatremia in children with gastroenteritis

摘要: Objectives. Nonosmotic antidiuretic hormone (ADH) activity can cause severe hyponatremia during involuntary fluid administration. We looked for evidence of this before and intravenous (IV) administration in children treated gastroenteritis. Methodology. In prospective observational study, plasma ADH, electrolytes, osmolality, glucose were measured 52 subjects (T0) 4 hours after (T4) starting 0.45% saline + 2.5% dextrose subsequently when indicated. Hormonal markers stress at T0. Urine samples collected to measure electrolytes osmolality. Results. The nonosmotic stimuli ADH secretion that we identified vomiting (50 52), dehydration (median: 5%; range: 3–8%), hypoglycemia (2 raised hormonal (mean ± SD: cortisol, 1094 589 nmol/L; reverse triiodothyronine, 792 293 pmol/L). At T0, half the hyponatremic (plasma sodium concentration Conclusions. are frequent with Their persistence IV-fluid predisposes dilutional hyponatremia. use hypotonic deficit replacement needs be reassessed.