Serum Electrolyte Alterations and Clinical Outcomes in Infants Admitted with Community-Acquired Infections: A Prospective Observational Study at a Tertiary Care Hospital

Pramod Padasalimani; Savitri Honakeri; Girish Hiremath

doi:10.37022/wjcmpr.v8i3.426

Authors

Pramod Padasalimani Senior resident, Department of Pediatrics, Koppal Institute of Medical Sciences (KIMS), Koppal, Karnataka, India
Savitri Honakeri Assistant Professor, Department of Pediatric Surgery, Karnataka Institute of Medical Sciences (KMCRI), Hubballi, Karnataka, India
Girish Hiremath Associate Professor , Department of Pediatrics, Koppal Institute of Medical Sciences (KIMS), Koppal, Karnataka, India

Abstract

Background: Acute community-acquired infections such as acute gastroenteritis (AGE), acute bronchiolitis, and urinary tract infection are common reasons for infant hospitalization. While hypernatremia was mainly noticed in gastroenteritis, electrolyte imbalances like hyponatremia are increasingly recognized across various acute pediatric infections. This study evaluated the prevalence of hyponatremia in infants admitted to Koppal Medical College and its correlation with clinical outcomes, including Pediatric Intensive Care Unit (PICU) admission, need for positive pressure ventilation (PPV), and total duration of stay.

Methods: A prospective observational study was conducted involving 120 consecutive infants aged 1 to 24 months admitted with community-acquired infections (AGE n=50, acute bronchiolitis n=45, uti n=25). Venous blood samples were collected at admission to analyze serum electrolytes {Na+, K+), renal parameters, and blood gas values. Clinical outcomes were compared between normonatremic (Na+ 135 mmol/L) and hyponatremic (Na+ < 135 mmol/L) infants, further stratifying hyponatremia severity (mild: 130-134mmol/L}, moderate: 125-129mmol/L}, severe: <125 mmol/L}).

Results: Hyponatremia was present in 58 out of 120 infants (48.3\%) at admission, most commonly in acute bronchiolitis (55.5%) and uti (52.0%), compared to AGE (40.0%). Infants with severe hyponatremia (n=12) experienced significantly poorer outcomes, demonstrating higher rates of PICU transfer (66.7% vs 11.3%, p < 0.001), increased requirement for positive pressure ventilation (50.0% vs 6.5%, p < 0.001), and prolonged length of PICU stay (6.2 pm 1.8 days vs 2.1 pm 0.8 days, p < 0.001) compared to normonatremic or near-normal sodium controls.

Conclusion: Dysnatremia, particularly hyponatremia, is highly prevalent among infants admitted with common community-acquired infections in a tertiary setup in northern Karnataka. Severe hyponatremia serves as a marker of disease severity and is directly associated with higher PICU utilization, mechanical respiratory support, and prolonged hospitalization.

Keywords:

Hyponatremia, Acute Gastroenteritis, Acute Bronchiolitis, Urinary Tract Infection, Infants, Pediatric Intensive Care Unit

DOI

https://doi.org/10.37022/wjcmpr.v8i3.426

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