RELATION OF GRADES OF HYPONATREMIA ON SEVERITY OF BRONCHIOLITIS

Abstract

Background and objectives: Hyponatremia often occurs among children with bronchiolitis. It is the most common electrolyte abnormality associated with severe disease course. Aim was to study relation between sodium levels and severity of bronchiolitis

Methodology: Cross-sectional study was conducted on 72 infants admitted with bronchiolitis to Pediatrics ward/ICU, JMMC. Infants with recurrent respiratory or super added bacterial infections, born <34weeks gestation, any chronic disorder or medications that can influence electrolyte levels or parents unwilling for consent were excluded. Severity of bronchiolitis was scored and classified into mild, moderate, severe. Sodium levels were determined and grouped (in mmol/L) into normonatremia (135-145) and hyponatremia (mild (130-134), moderate (125-129) and severe (?124). The grade of hyponatremia with severity of bronchiolitis was compared. Chi square test was used to test the association of severity of bronchiolitis and category of hyponatremia. ANOVA test was done to compare the severity of bronchiolitis with sodium levels.

Results: Hyponatremia was seen in 50% of cases admitted with severe bronchiolitis, which when compared to mild and moderate bronchiolitis, was statistically significant (p<0.001). ANOVA showed mean sodium levels of mild, moderate and severe bronchiolitis were 138.44±1.81, 137.37±1.76 and 135.43±3.93 respectively; these were statistically significant (p<0.001). A pairwise comparison between mild and moderate bronchiolitis with hyponatremia was not found to be statistically significant (p-0.769) but comparison between mild and severe bronchiolitis with hyponatremia was statistically significant (p<0.001)

Conclusion: There is statistically significant relation between hyponatremia and severity of bronchiolitis. Hyponatremia could be considered as a marker to assess the severity of bronchiolitis.

Keywords:  Bronchiolitis, Hyponatremia, Respiratory distress