The water and
electrolyte status was studied in 26 children with acute
asthma, 8 of whom required hospital admission. Patients were evaluated before
therapy, during hospital management, and at least 10 days after symptoms had subsided. Laboratory evaluation included serum
electrolytes, BUN, sOsmo, urinalysis, and uOsmo. Data were analyzed for the manifestations of SI-ADH. Mild serum hyposmolarity was noted initially in only two patients and during the
hospital stay in one patient for a short time, but none of the patients fulfilled the criteria of
SIADH. At the time of presentation at the emergency room, none of the 26 patients had clinical signs of
dehydration, yet some degree of hypertonicity seemed to be present in most patients. This study shows that children with acute
asthma are ordinarily not at high risk of
SIADH and
fluid therapy should be included in the management. Nevertheless, because such patients may be at risk of
pulmonary edema, vigorous fluid administration should be discouraged, except to correct
dehydration.