We read with interest the article published by Dr. Eulmesekian and colleagues (1) published in Pediatric Critical Care Medicine describing hyponatremia in postoperative pediatric patients admitted to a pediatric intensive care unit. There is discordance between the definition of hyponatremia in the introduction (<130 mmol/L) and the conservative definition the authors used in the methodology as the primary end point (<136 mmol/L). The mean plasma sodium in patients who did meet the primary end point was 133 mmol/L at 12 hrs and 134 mmol/L at 24 hrs. Both of these degrees of hyponatremia are usually asymptomatic; however, the authors conclude by stating that, "this study assists the clinician in an understanding of the frequency of severe hyponatremia and how to best detect it."
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