Dissociation of osmoregulation from plasma arginine vasopressin levels following thermal injury in childhood

Although the syndrome of inappropriate anti-diuretic hormone secretion has been recognised as a complication associated with burn and other trauma in adults, relatively little is known about its incidence in children. The obj ective of this study was to investigate whether it is a complication associ ated with burn injury in children. Plasma and urine levels of arginine vaso pressin (anti-diuretic hormone), sodium and osmolality were measured in sam ples collected from 16 burn-injured children admitted to the burns unit of the regional children's hospital. No significant correlations were found be tween plasma vasopressin and plasma sodium or osmolality levels, but there were significant correlations between plasma vasopressin and urine osmolali ty, 36 (r = 0.74, p = 0.009), 60 (r = 0.92, p = 0.000) and 84 h (r = 0.84, p = 0.001) after admission, respectively. There were also significant corre lations between plasma sodium and plasma osmolality, 24 (r = 0.7, p = 0.005 ), 36 (r = 0.57, p = 0.04) and 84 h (r = 0.84, p = 0.004) after admission. The data suggest dissociation between the osmolar control of vasopressin se cretion and vasopressin levels after burn injury in children, but do not su pport the incidence of inappropriate secretion of antidiuretic hormone. (C) 2000 Elsevier Science Ltd and ISBI. All rights reserved.