Abstract
Twelve children (age:3 mos to 7 mos, sex:m:f::8:4) known to have bronchopulmonary dysplasia were studied for antidiuretic hormone response during hospitalization with respiratory distress, hypoxemia and hyperinflation on chest x-ray. 7/12 had wheezing at the time of admission. None had received any medications before admission. None of the children had clinical evidence of dehydration (normal plasma renin activity of 2.4–4.7 ng/ml). Plasma ADH levels were measured by radioimmune assay (N=up to 1.7 mU/ml) and were elevated 6–9 fold (2.4 mU/ml–3.1 mU/ml) within 7–10 days. 3/12 children developed hyponatremia (129–131) 24 hours after admission. Further, 2/3 children with hyponatremia developed diastolic hypertension for up to 2 days. 7/12 were given furosemide at the time of admission for the presence of wheezing. Though the wheezing diminished considerably following furosemide, there was no reduction in the plasma ADH levels. We conclude that 1. ADH secretion is common in children with BPD during acute respiratory distress 2. The mechanism for the production of ADH is either hypoxemia and/or hyperinflation 3. Hyponatremia occurs with increased ADH secretion and therefore care should be exercised in the administration of fluids 4. Though furosemide may have a beneficial effect on the respiratory distress in children with BPD, the plasma ADH levels are not influenced by its administration and 5. The continued ADH secretion in children with BPD feeds a vicious cylcle.
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Rao, M., Eid, N., Mitchell, M. et al. 1816 ANTIDIURETIC HORMONE (ADH) SECRETION DURING RESPIRATORY DISTRESS IN CHILDREN WITH BRONCHOPULMONARY DYSPLASIA (BPD). Pediatr Res 19, 413 (1985). https://doi.org/10.1203/00006450-198504000-01834
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DOI: https://doi.org/10.1203/00006450-198504000-01834