PMID- 34018137 OWN - NLM STAT- MEDLINE DCOM- 20211105 LR - 20211105 IS - 0973-7693 (Electronic) IS - 0019-5456 (Linking) VI - 88 IP - 11 DP - 2021 Nov TI - A Prospective Cohort Study on Serum Sodium and Clinical Outcome in Pediatric Nontraumatic Coma. PG - 1092-1098 LID - 10.1007/s12098-021-03726-4 [doi] AB - OBJECTIVE: To study the serum sodium level and clinical outcome in pediatric nontraumatic coma. METHODS: A prospective cohort study was conducted in a tertiary care pediatric intensive care unit (PICU) from September 2015 to June 2016. Children aged < 13 y with nontraumatic coma [modified-Glasgow Coma Scale (m-GCS) score /= 3 from baseline within 24 h of admission] were included. Children who received intravenous fluids for > 24 h, those with developmental delay, or died within 24 h of admission were excluded. The serum sodium profile (mEq/L) in the first 72 h and clinical outcome [mortality, length of stay in mechanical ventilation, PICU, and hospital] were studied. RESULTS: Eighty patients [Died n = 26 and Survived n = 54] were enrolled. Median [interquartile range (IQR)] age and m-GCS were 21 (4-78) mo and 9 (7-11), respectively. The mean [standard deviation (SD)] Pediatric Risk of Mortality-III (PRISM-III) was 17.7 (4). The most common etiology was acute central nervous system (CNS) infections (30%, n = 24) followed by an intracranial bleed (11.3%, n = 9). Mean (Standard error, SE) sodium levels and fluctuation of serum sodium from baseline up to 72 h were similar between nonsurvivors and survivors [140.8 (1.3) vs. 139.6 (0.8), p = 0.421] and [1.2 (0.3) vs. 0.8 (0.2), p = 0.307], respectively. On multivariate analysis, the need for vasoactive therapy was an independent predictor of mortality [adjusted odds ratio = 20.78, 95% CI 4.24-101.85, p = < 0.001, R(2) = 0.62]. CONCLUSION: Mean serum sodium within normal range and fluctuation of serum sodium of 0.8 to 1.2 mEq/L over 72 h was not associated with poor outcomes in pediatric nontraumatic coma. Vasoactive therapy was an independent predictor of mortality. CI - (c) 2021. Dr. K C Chaudhuri Foundation. FAU - Gupta, Akanksha AU - Gupta A AD - Division of Pediatric Critical Care, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605 006, India. FAU - Rameshkumar, Ramachandran AU - Rameshkumar R AUID- ORCID: 0000-0002-1911-3473 AD - Division of Pediatric Critical Care, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605 006, India. krramesh_iway@yahoo.co.in. FAU - Chidambaram, Muthu AU - Chidambaram M AD - Division of Pediatric Critical Care, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605 006, India. FAU - Selvan, Tamil AU - Selvan T AD - Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India. FAU - Mahadevan, Subramanian AU - Mahadevan S AD - Division of Pediatric Critical Care, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605 006, India. LA - eng PT - Journal Article DEP - 20210520 PL - India TA - Indian J Pediatr JT - Indian journal of pediatrics JID - 0417442 RN - 9NEZ333N27 (Sodium) SB - IM EIN - Indian J Pediatr. 2021 Sep 29;:. PMID: 34585326 MH - Child MH - *Coma/diagnosis/therapy MH - Glasgow Coma Scale MH - Humans MH - Infant MH - *Intensive Care Units, Pediatric MH - Prospective Studies MH - Retrospective Studies MH - Sodium OTO - NOTNLM OT - Children OT - Mortality OT - Nontraumatic coma OT - Serum sodium EDAT- 2021/05/22 06:00 MHDA- 2021/11/06 06:00 CRDT- 2021/05/21 06:43 PHST- 2020/10/12 00:00 [received] PHST- 2021/03/02 00:00 [accepted] PHST- 2021/05/22 06:00 [pubmed] PHST- 2021/11/06 06:00 [medline] PHST- 2021/05/21 06:43 [entrez] AID - 10.1007/s12098-021-03726-4 [pii] AID - 10.1007/s12098-021-03726-4 [doi] PST - ppublish SO - Indian J Pediatr. 2021 Nov;88(11):1092-1098. doi: 10.1007/s12098-021-03726-4. Epub 2021 May 20.