COMPARISON OF METHODOLOGIES

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Hyponatremia is one of the commonest encountered electrolyte disorders in most pediatric children. However, this disorder contributes to substantial mortality and morbidity among patients admitted to Pediatric Intensive Care Unit (PICU). The disorder can easily be described using variable frequencies in majority of children and young adults. In most cases, these described variable frequencies differ based on the level of hyponatremia and the difference in age among pediatric patients (Berry & Belsha 1999). In the process of acquiring data from previous studies, the Prasad et al. and the Indian studies produced enough information that yielded similar observation as that in our research methodology. In order to understand how our methodology differs from that of Prasad et al. and the Indian study, sample sizes of all pediatrics and variables, such as the level of sodium in pediatric patients, will be used.

Sample size

From our study, a sample size of children aged from 1 month to 12 years was taken, where some of them needed immediate admission to PICU after presenting a case of hyponatremia, and others whose hyponatremia were corrected before their admission to PICU, were excluded. In comparison to the Indian study, a sample size of children from the age of 1 month to 14 years was taken during summers and winters. In addition, Prasad et al. study used a sample size of children up to 12 years during the summer irrespective of their primary diagnosis or severity of the illness.

Variables

Our study defines sodium level of 131-135 as mild hyponatremia, 125-130 as moderate hyponatremia and less than 125 as severe hyponatremia. In comparison to the Indian study, it classified its patients with sodium level of 130-135 as mild hyponatremia, 125-130 as moderate hyponatremia and less than 125 as severe hyponatremia. Additionally, Prasad et al. study, grouped patients on the basis of sodium level of less that 130 as mild hyponatremia, greater that 130 as moderate hyponatremia, and less than 125 as severe hyponatremia.

FREQUENCY OF HYPONATREMIA IN DIFFERENT OTHER DISEASES

Hyponatremia is a frequent finding in most children with pneumonia. Usually, it consist of part of the syndrome of improper secretion of anti-diuretic hormone (SIADH), which results in water preservation with slight weight gain, commonly with lack of oedema formation, and a standard blood pressure (Shann & Germer, 1996). According to research made by Prasad et al. (1994) and Prasad et al. (1997), SIADH occur in approximately one third of children admitted due to cases of pneumonia, and was related with a more severe disease and a poorer result. The lower respiratory infections, which include pneumonia, asthma, and bronchitis, still continue to threaten the health of children all over the world, mostly in developing nations, where there is poor nutrition and scarce health care access.

HYPONATREMIA AND HOSPITAL LENGTH OF STAY

In our findings, hospital-acquire hyponatemia in men (58.1%), resulted in increases in length of hospital stay that were associated with the severity of hospital-acquired hyponatremia as compared to women (41.9%). Other previous studies done assume that during hospitalization, the occurrence of hyponatremia may represent an important factor that influences the outcome and the length of hospital stay (Chiang, Wattad & Hill, 1992). Active effective and timely on the standardization of sodium levels might have a positive effect on the diagnosis of the pediatric patients setting, in addition to the length of hospital stay, thus potentially reducing patients costs in hospitals.

MORTALITY

Additionally, the level of mortality linked to hyponatremia is frequently high. It is sometimes hard to establish the exact hyponatremias effect to the rates of mortality as a result of the traditional other high risk co-morbid disorders coexistence. For instance, some researches assume that patients who developed seizures have a higher mortality level. Nevertheless, extreme hyponatremia in pediatric patients is frequently linked to 20-times higher mortality especially in alcoholics. In the availability of substantial co-morbidity disorders, it is sometimes difficult to evaluate the exact effect of hyponatremia that would result to death (Fraser, Ayus & Arieff 1992).

REFERENCES

Chiang ML, Wattad A & Hill LL. (1992). Hyponatremia in hospitalized children. Chicago:

Chicago University Press. Print

Fraser CL, Ayus JC & Arieff AI. (1992). Hyponatremia and death or permanent brain damage

in healthy children. London: McGraw Hill. Print

Shann F & Germer S. (1996). Hyponatremia associated with pneumonia or bacterial meningitis.

Arch Dis Child. New York: Prentice Hall. Print

Berry PL & Belsha CW. (1999). Hyponatremia. Pediatric Clinic North America. Arch Dis Child.

New York: New York University Press. Print

Prasad et al. (1997). Hyponatremia in sick children seeking pediatric emergency care. Indian

Pediatrics. India: University College of Medical Science and GTB Hospital

Prasad et al. (1994). Hyponatremia in sick children: A market of serious illness. Indian

Pediatrics. India: University College of Medical Science and GTB Hospital

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