We report three paediatric cases of severe dehydration and hyponatraemia with circulatory compromise associated with the use of external ventricular drainage of cerebrospinal fluid. Two of the children had cardiac arrests. All were successfully resuscitated. While there were additional factors that contributed to other fluid losses, and fluid balance data are incomplete, these cases highlight a need for increased vigilance when managing children with external ventricular drains.
TobiasJ.D.Cerebrospinal fluid losses through ventricular catheters leading to hyponatremia in two children.South Med J1991; 84: 279–280.
2.
MacMahonP., CookeR.W.Hyponatraemia caused by repeated cerebrospinal fluid drainage in post haemorrhagic hydrocephalus.Arch Dis Child1983; 58: 385–386.
3.
DrakeJ.M., Sainte-RoseC., DaSilvaM., HirschJ.F.Cerebrospinal fluid flow dynamics in children with external ventricular drains.Neurosurgery1991; 28: 242–250.
4.
YasudaT., TomitaT., McLoneD.G., DonovanM.Measurement of cerebrospinal fluid output through external ventricular drainage in one hundred infants and children: correlation with cerebrospinal fluid production.Pediatr Neurosurg2002; 36: 22–28.
5.
VenkateshB., ScottP., ZiegenfussM.Cerebrospinal fluid in critical illness.Critical Care and Resuscitation2000; 2: 42–54.
6.
NevilleK.A., VergeC.F., O'MearaM.W., WalkerJ.L.High anti-diuretic hormone levels and hyponatremia in children with gastroenteritis.Pediatrics2005; 116: 1401–1407.
7.
LeeS.J., HuhE.J., ByeonJ.H.Two cases of cerebral salt wasting syndrome developing after cranial vault remodeling in craniosynostosis children.J Korean Med Sci2004; 19: 627–630.
8.
ByeonJ.H., YooG.Cerebral salt wasting syndrome after calvarial remodeling in craniosynostosis.J Korean Med Sci2005; 20: 866–869.
9.
LevineJ.P., StelnickiE., WeinerH.L., BradleyJ.P., McCarthyJ.G.Hyponatremia in the postoperative craniofacial pediatric patient population: a connection to cerebral salt wasting syndrome and management of the disorder.Plast Reconstr Surg2001; 108: 1501–1508.
10.
AllnuttM.F.Human factors in accidents.Br J Anaesth1987; 59: 856–864.
11.
RuncimanW.B., SeilenA., WebbR.K.The Australian Incident Monitoring Study. Errors, incidents and accidents in anaesthetic practice.Anaesth Intensive Care1993; 21: 506–519.
