"Drink plenty of fluids"
http://www.100md.com
《英国医生杂志》
EDITOR—We carefully worded our systematic review: there is no direct empirical evidence to support or refute the advice; we ask only that more research is undertaken, and that in the meantime we exercise caution with the age old advice. That the press has run away with a slightly different, sensationalised, slant probably will surprise few, and outrage fewer.
But let us look deeper at the indirect evidence. Although an observational study of children with infections of the upper respiratory tract with respiratory syncytial virus showed no increase in secretions of antidiuretic hormone,1 two case reports describe children with only infections of the upper respiratory tract with hyponatraemia and seizures—one a bottle-fed 10 week old child with a mild cold who was given water and herbal teas over three days2; the other a 5 week old with upper respiratory symptoms, conjunctivitis, and poor feeding for two days.3 In infections of the lower respiratory tract, observational studies show that increased secretion of antidiuretic hormone occurs in bronchiolitis, where it is the norm, not just very ill patients with pneumonia.1 4 5 It is becoming standard management to advise careful monitoring and restriction of fluid intake with bronchiolitis.
Would it be responsible to continue to advise the wholesale overhydration of children with acute respiratory infections, even in the absence of empirical data?
Michelle P B Guppy, academic general practice registrar
Centre for General Practice, Medical School, University of Queensland, Herston, Qld 4006, Australia
Sharon M Mickan, senior research fellow
Centre for General Practice, Medical School, University of Queensland, Herston, Qld 4006, Australia
Chris B Del Mar, professor of general practice
c.delmar@cgp.uq.edu.au, Centre for General Practice, Medical School, University of Queensland, Herston, Qld 4006, Australia
Competing interests: None declared.
References
van Steensel-Moll HA, Hazelzet JA, van der Voort E, Neijens HJ, Hackeng WH. Excessive secretion of antidiuretic hormone in infections with respiratory syncytial virus. Arch Dis Child 1990;65: 1237-9.
Lipsitz DJ. Herbal teas and water intoxication in a young child. J Fam Pract 1984;18: 933-37.
Lubitz L. Inappropriate anti-diuretic hormone secretion and bronchiolitis: a case report. Aust Paediatr J 1982;18: 67.
Gozal D, Colin AA, Jaffe M, Hochberg Z. Water, electrolyte, and endocrine homeostasis in infants with bronchiolitis. Pediatr Res 1990;27: 204-9.
Poddar U, Singhi S, Ganguli NK, Sialy R. Water electrolyte homeostasis in acute bronchiolitis. Indian Pediatr 1995;32: 59-65.
But let us look deeper at the indirect evidence. Although an observational study of children with infections of the upper respiratory tract with respiratory syncytial virus showed no increase in secretions of antidiuretic hormone,1 two case reports describe children with only infections of the upper respiratory tract with hyponatraemia and seizures—one a bottle-fed 10 week old child with a mild cold who was given water and herbal teas over three days2; the other a 5 week old with upper respiratory symptoms, conjunctivitis, and poor feeding for two days.3 In infections of the lower respiratory tract, observational studies show that increased secretion of antidiuretic hormone occurs in bronchiolitis, where it is the norm, not just very ill patients with pneumonia.1 4 5 It is becoming standard management to advise careful monitoring and restriction of fluid intake with bronchiolitis.
Would it be responsible to continue to advise the wholesale overhydration of children with acute respiratory infections, even in the absence of empirical data?
Michelle P B Guppy, academic general practice registrar
Centre for General Practice, Medical School, University of Queensland, Herston, Qld 4006, Australia
Sharon M Mickan, senior research fellow
Centre for General Practice, Medical School, University of Queensland, Herston, Qld 4006, Australia
Chris B Del Mar, professor of general practice
c.delmar@cgp.uq.edu.au, Centre for General Practice, Medical School, University of Queensland, Herston, Qld 4006, Australia
Competing interests: None declared.
References
van Steensel-Moll HA, Hazelzet JA, van der Voort E, Neijens HJ, Hackeng WH. Excessive secretion of antidiuretic hormone in infections with respiratory syncytial virus. Arch Dis Child 1990;65: 1237-9.
Lipsitz DJ. Herbal teas and water intoxication in a young child. J Fam Pract 1984;18: 933-37.
Lubitz L. Inappropriate anti-diuretic hormone secretion and bronchiolitis: a case report. Aust Paediatr J 1982;18: 67.
Gozal D, Colin AA, Jaffe M, Hochberg Z. Water, electrolyte, and endocrine homeostasis in infants with bronchiolitis. Pediatr Res 1990;27: 204-9.
Poddar U, Singhi S, Ganguli NK, Sialy R. Water electrolyte homeostasis in acute bronchiolitis. Indian Pediatr 1995;32: 59-65.