Role of serum osmolarity as an indicator for neurological morbidity in children with acute central nervous illness

Abstract

Acute CNS illness comprising of Acute CNS infections along with Traumatic head Injury is an important cause for significant morbidity and mortality in Pediatric Intensive Care units across the world. Osmolar changes in the blood correlate well with CNS status. Acute BM is still a meaningful, host-pathogen interaction responsible for bacterial invasion of the CNS Osmolality in children with CNS illness is a good indicator of assessing neurological Morbidity and Mortality. A complex neuroendocrine system is involved in the maintenance of sodium and water homeostasis. Bacterial Meningitis (BM) is an acute purulent infection of the meninges. It is the most common bacterial infection of the CNS & it’s the medical emergency that still has high mortality and morbidity. Blood-Brain Barrier is relatively impermeable to sodium, but water crosses freely. Variety of result in sodium dysregulation such as Traumatic Brain Injury, pyogenic meningitis, viral encephalitis, which is associated with significant Mortality and Morbidity. The objective of our study is to determine the incidence and outcome of Serum Osmolar change in children presenting with acute neurological illness. A prospective observational study was carried out between Jan 6^th  2020-March 6^th 2020 enrolling children between ages of 1 month to 15 years, admitted to the PICU of SMCH with Acute onset neurological illness. Among 40 children, 20 children with hyponatremia have 50% of neurological deficit, Children with hypernatremia 50% had Neurological deficit, which is not statistically significant at P value 0.083. Among the 40 children 40% had low Osmolality, 25% have high Osmolality & 35% had normal range, which is not statistically significant at P value 0.199