Hypernatremia in neonates. A case based discussion. Dr Sridhar Kalyanasundaram

Hypernatremia is one of the preventable causes of brain injury in neonates. This can be prevented by appropriate support to breast feeding and close follow up of the babies in the postnatal period to ensure the feeding is established normally. In this video, I review this topic based on a real case. The details of correction are not specified, but are available in all emergency handbooks. Please share.
I will make another video soon focusing on the correction.

[@SridharKs]

Useful playlists for nicu nurses, trainee pediatricians and neonatal trainees NRP-kzbin.info/aero/PLKe2uxLSi6cErI1Y7ZRbLub-1Qq8AT4Bm Oxygen in Neonatology kzbin.info/aero/PLKe2uxLSi6cEDL9Zfc57-YJjlVkqJXmQp Neonatal ventilation-kzbin.info/aero/PLKe2uxLSi6cEk8ExzMpF-5ePzmkteTNjk Neonatal jaundice-kzbin.info/aero/PLKe2uxLSi6cFT5aOxCrU9ENBRXlkUwWzq Breastfeeding-kzbin.info/aero/PLKe2uxLSi6cFdnNrlnJQ8T5P-qaP8erc5 And many short videos to clarify queries of new parents-could help if you cover postnatal ward kzbin.info/aero/PLKe2uxLSi6cEAuXao6M9lsXUmbyhbpL1t

[@madhukardeshpande563]

Nice explanation sir.

[@SridharKs]

Thank you

[@TheLivert]

good presentation although the correction of Na with free water, must be taken out in a water deficit and add this to the basal requirements without stopping administering the basal sodium.

[@SridharKs]

Thank you-I have added a slide to the comment on my facebook group to clarify this. I will prepare a presentation on this too.

[@monishajames4928]

Very informative... Thanks Sir...!!!

[@SridharKs]

Thank you

[@manjum4203]

Thank you very much sir for uploading video..

[@SridharKs]

Thank you

[@ememescr]

this is a difficult topic

[@gayathrigandhi2942]

Sir, what is the definition of hyponatremia in newborns.. is it na less than 130 or 135 meq/l..please do post a video on management of hyponatremia in newborns..

[@SridharKs]

There is one already kzbin.info/www/bejne/sGiVhXuCgKicsJY

[@SridharKs]

As for definition, it is below 135 but clinical relevance is more below 130

[@gayathrigandhi2942]

@@SridharKs thank you sir..!

[@gayathrigandhi2942]

Hello sir, when can we evaluate a baby for hypernatremic dehydration. Cumulative weight loss of a term baby is 11% on day 4 .Urine output is good. No records of fever. Should this baby be evaluated for hypernatremia?

[@SridharKs]

Since the features suggest improvement, ensure feeding support, suggest EBM topup to improve same and to ensure no further dehydration. I would review after 24 hours and if improving, no further action apart from usual

[@gayathrigandhi2942]

@@SridharKs thank u sir

[@SridharKs]

@@gayathrigandhi2942 hope TCB is ok

[@gayathrigandhi2942]

@@SridharKs the baby had mild hypernatremia sir (sodium was 147 meq/l). Just on top up breastmilk ..no red flag signs or symptoms..discharged and advised review after 48 hours

[@SridharKs]

@@gayathrigandhi2942 great, thank you

[@user-tl5db6ro5j]

Thanks for this video sir Wich formula we can use to calculate the amount of water ? Why we use 100ml/kg in five day

[@SridharKs]

I have explained the calculation in this video, kzbin.info/www/bejne/j3iopnWGltigja8

[@SridharKs]

In that particular case. The 100 ml per kg is not standard but start slowly and monitor closely. Rapid correction is not good

[@vikrantsingh47]

Hi sir, unfortunately my baby girl of 16 days has got high sodium (169) and was admitted to NICU. Niw after 2 days the sodium levels are 147. I am very concerned about the possibility of brain damage. What are the chances of permanent brain damage and can we determine the brain damage using MRI scan? What signs we need to observe for possible brain damage. Also, if the baby is not able to get proper breast milk, should we also give her formula milk to prevent high sodium levels again. Please respond, thanks.

[@SridharKs]

If baby is neurologically normal, hopefully everything will be ok. MRI if any concerns. We need to use formula if breastmilk not adequate. Use breast pump to improve output for a few weeks. What was the weight loss

[@SridharKs]

Review this How to improve breast milk output during the initial days of feeding. Dr Sridhar #breastfeeding kzbin.info/www/bejne/ep7CkIesbc-XqbM

[@vikrantsingh47]

@@SridharKs weight loss was around 500 gm

[@SridharKs]

@@vikrantsingh47 ok, follow up closely and monitor development. Stay positive

[@aklhassan4732]

what about hypernatremia in VELBW babies?

[@SridharKs]

Hi, will cover that when I cover fluid balance

[@aklhassan4732]

Thank you sir

[@arpitkansal5774]

Hello sir, my baby is in same situation. Can we connect over a short call.

[@SridharKs]

Hi, you can email your details. Are you in Dubai

[@arpitkansal5774]

@@SridharKs sure sir, no I m from Delhi, India. Please share your email id.

[@SridharKs]

@@arpitkansal5774 [e-mail]

[@babumadarkar]

Sir where is playlist

[@SridharKs]

Hi, do you mean the one for parents? Please check this. You can find other playlists as well once you click on channel details. kzbin.info/aero/PLKe2uxLSi6cF7AGIGsAads-O9cgyQAkwj

[@gayathrigandhi2942]

Hello sir..does a serum potassium level of 3.3 meq/l warrant any clinical intervention? Clinical history: a 36 week preterm neonate was found to have the above level on routine blood work up. Baby is otherwise doing well.. Kindly guide sir..thank you..

[@SridharKs]

Hi, if baby is on full feeds and otherwise well, I would repeat in a couple of days. If on IV fluids, we could add a little more to maintenance potassium. If it is dropping further, better to evaluate (urine electrolytes, blood gas, RFT, and other work up)

[@gayathrigandhi2942]

@@SridharKs thank you sir