Ūdens intoksikācija zīdaiņu vecumā: klīnisko gadījumu analīze
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Date
2023
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ūdens intoksikācija, ko sauc arī par hiperhidratāciju, ir viens no biežākajiem simptomātis-kas dilūcijas hiponatriēmijas cēloņiem veseliem zīdaiņiem; 70 % zīdaiņu, kuri jaunāki par 6 mēne-šiem un, kuriem attīstās krampji bez redzama iemesla, ir konstatēta hiponatriēmija dēļ ūdens in-toksikācijas.
Ir apskatīti divi klīniskie gadījumi saistībā ar zīdaiņu ūdens intoksikāciju un veikts retros-pektīvs pētījums, analizējot VSIA “Bērnu klīniskā universitātes slimnīca” arhīvā esošās pacientu elektroniskās vēstures.
Pirmajā gadījumā prezentēta paciente, kura ir 1 mēnesi un 29 dienas veca, ar ilgstošiem ģeneralizētiem krampjiem, sliktāku reakciju uz sākotnējo terapiju un ilgāku hospitalizācijas laiku.
Otrajā gadījumā apskatīta 8 mēnešus veca meitene ar īslaicīgām krampju lēkmēm, labāku reakciju uz sākotnējo terapiju un mazāku hospitalizācijas laiku.
Abos gadījumos pēc hiponatriēmisko krampju kupēšanas un hiponatriēmijas korekcijas lēkmes vairs nav atkārtojušās.
Literatūrā tiek aprakstītas divas zīdaiņu ar hiponatriēmiju grupas – ar ūdens intoksikāciju un ar SIADH sindromu. Tāpēc abos gadījumos bija nepieciešams izslēgt SIADH sindromu kā hiponatriēmijas iemeslu.
Klīnisko gadījumu analīzes mērķis ir veicināt zīdaiņu ūdens intoksikācijas kā retas patolo-ģijas labāku atpazīstamību, tajā skaitā arī starp ģimenes ārstiem.
Pētījuma uzdevumi:
1. Analizēt klīniskos gadījumus.
2. Analizēt atbilstošo zinātnisko literatūru.
3. Noteikt zīdaiņu vecuma ūdens intoksikācijas riska faktorus, patoģenēzes mehānismu, klīnisko gaitu un iznākumus.
4. Sniegt rekomendācijas par drošu ūdens lietošanu ikdienā zīdaiņu vecumā.
Water intoxication, also called hyperhydration, is one of the most common causes of symptomatic dilutional hyponatremia in healthy infants; hyponatremia due to water intoxication is found in 70% of infants younger than 6 months with convulsions of unexplained cause. Two clinical cases related to water intoxication in infants are reviewed and the retrospective research is made by analysing electronic versions of patients’ medical histories of VSIA the Children's Clinical University Hospital. In the first case, a patient aged 1 month and 29 days was presented with persistent generalized convulsions, worse response to oral therapy and longer hospitalization. In the second case, an 8-month-old girl with brief seizures was presented, with better response to initial treatment, and less hospitalization time. In both cases, after stopping the hyponatraemic seizures and correcting the hyponatremia, the seizures did not recur anymore. In the literature there are described two groups of infants with hyponatremia - with water intoxication and with SIADH syndrome. Therefore, it was necessary to exclude SIADH syndrome as cause of hyponatremia in both cases. The aim of the analysis of clinical cases is to promote better recognition of infant water intoxication as a rare pathology, including among family physicians. Research tasks: 1. To analyse clinical cases. 2. To gather, select and analyse relevant scientific literature. 3. To determine the risk factors, mechanism of pathogenesis, clinical gait and outcomes of water intoxication in infants. 4. To provide recommendations on safe daily use of water in infants.
Water intoxication, also called hyperhydration, is one of the most common causes of symptomatic dilutional hyponatremia in healthy infants; hyponatremia due to water intoxication is found in 70% of infants younger than 6 months with convulsions of unexplained cause. Two clinical cases related to water intoxication in infants are reviewed and the retrospective research is made by analysing electronic versions of patients’ medical histories of VSIA the Children's Clinical University Hospital. In the first case, a patient aged 1 month and 29 days was presented with persistent generalized convulsions, worse response to oral therapy and longer hospitalization. In the second case, an 8-month-old girl with brief seizures was presented, with better response to initial treatment, and less hospitalization time. In both cases, after stopping the hyponatraemic seizures and correcting the hyponatremia, the seizures did not recur anymore. In the literature there are described two groups of infants with hyponatremia - with water intoxication and with SIADH syndrome. Therefore, it was necessary to exclude SIADH syndrome as cause of hyponatremia in both cases. The aim of the analysis of clinical cases is to promote better recognition of infant water intoxication as a rare pathology, including among family physicians. Research tasks: 1. To analyse clinical cases. 2. To gather, select and analyse relevant scientific literature. 3. To determine the risk factors, mechanism of pathogenesis, clinical gait and outcomes of water intoxication in infants. 4. To provide recommendations on safe daily use of water in infants.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Zīdaiņu ūdens intoksikācija, status epilepticus, SIADH., Infant water intoxication, status epilepticus, SIADH.