keyword
https://read.qxmd.com/read/35787494/benefit-of-natriuresis-and-cardiac-resynchronisation-therapy-in-acute-decompensated-heart-failure-with-cardiorenal-syndrome-and-hypernatraemia
#21
JOURNAL ARTICLE
Abdulrahman Tawfiq Khojah, Emma Katz, Romina Pace, Rajkumar Rajendram
A man in his eighties with acute heart failure and cardiorenal syndrome developed severe hypernatraemia with diuresis. In this situation, palliation is often considered when renal replacement therapy is inappropriate. The literature to guide treatment of dysnatraemia in this setting is limited. Diuretics often worsen hypernatraemia and fluid replacement exacerbates heart failure. We describe a successful approach to this clinical Catch-22: sequential nephron blockade with intravenous 5% dextrose. Seemingly counterintuitive, the natriuretic effect of this combination had not previously been compared with diuretic monotherapy for heart failure...
July 4, 2022: BMJ Case Reports
https://read.qxmd.com/read/35475321/too-much-of-a-good-thing-bicarbonate-toxicity-following-treatment-of-sodium-channel-blocker-overdose
#22
JOURNAL ARTICLE
Katherine Z Isoardi, Angela L Chiew
Although sodium bicarbonate can be a life-saving antidote for patients with overdoses resulting in sodium channel blockade, there has been a concerning rise in cases referred to the Poisons Information Centre where inappropriately large doses of bicarbonate have been used resulting in iatrogenic harm. We present a series of three clinical cases where excessive bicarbonate was used to treat poisonings and discuss our approach to managing cardiotoxicity secondary to sodium channel blockade. Serial blood gas analysis should be performed when using bicarbonate to ensure pH targets are met and severe alkalaemia, hypernatraemia and hypokalaemia are avoided...
August 2022: Emergency Medicine Australasia: EMA
https://read.qxmd.com/read/35380521/laboratory-parameters-associated-with-prolonged-hospital-length-of-stay-in-covid-19-patients-in-johannesburg-south-africa
#23
JOURNAL ARTICLE
J Pillai, P P K Mistry, D A Le Roux, K S C Motaung, M Mokgatle, P Gaylard, N Cengiz, D Basu
BACKGROUND: Coronavirus disease (COVID-19) has imposed unprecedented stressors on South Africa (SA)'s healthcare system. Superimposed on the country's quadruple burden of disease, pandemic-related care further exposes existing inequities. Some of these inequities are specific to hospital-based inpatient services, such as the geographical maldistribution of hospital beds, lack of oxygen supplies and assisted ventilation, and scarcity of trained healthcare workers. Certain high-risk groups, such as individuals with cardiometabolic comorbidity, are likely to develop severe COVID-19 disease requiring hospitalisation with potential for a prolonged length of stay (LoS)...
March 1, 2022: South African Medical Journal
https://read.qxmd.com/read/35370669/effectiveness-of-sodium-bicarbonate-infusion-on-mortality-in-critically-ill-children-with-metabolic-acidosis
#24
JOURNAL ARTICLE
Huabin Wang, Rui Liang, Tianqi Liang, Songyao Chen, Yulong Zhang, Lidan Zhang, Chun Chen
Objective: Metabolic acidosis often occurs in the paediatric intensive care unit (PICU). Although sodium bicarbonate (SB) has been widely used in paediatrics, data on the effect of SB on children with metabolic acidosis in the PICU are scarce. Methods: Patients with metabolic acidosis who were treated with SB within 48 h of PICU admission were screened. Multivariate logistic regression, subgroup analysis, and propensity score matching (PSM) were used to investigate the relationships between SB infusion and clinical outcomes...
2022: Frontiers in Pharmacology
https://read.qxmd.com/read/35125534/health-and-nutritional-status-of-children-hospitalized-during-the-covid-19-pandemic-bangladesh
#25
JOURNAL ARTICLE
Sharika Nuzhat, Sm Tafsir Hasan, Parag Palit, Farzana Afroze, Rukaeya Amin, Md Ashraful Alam, Baharul Alam, Mohammod J Chisti, Tahmeed Ahmed
OBJECTIVE: To compare the health and nutrition of children younger than 5 years admitted to hospital during and before the coronavirus disease 2019 (COVID-19) pandemic in Bangladesh. METHODS: We collected data from hospital records of children 0-59 months admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh in March 2020-February 2021 (COVID-19 period; n  = 2552) and March 2019-February 2020 (pre-COVID-19 period; n  = 6738)...
February 1, 2022: Bulletin of the World Health Organization
https://read.qxmd.com/read/35048163/use-of-normal-saline-and-incidence-of-dyselectrolytaemia-in-children-following-kidney-transplantation
#26
JOURNAL ARTICLE
Samantha J Williamson, Nicholas D Plant, Mohan Shenoy
BACKGROUND: The use of hypotonic fluid, such as 0.45% saline, following kidney transplantation (KT) in children is associated with a high incidence of electrolyte imbalance, especially hyponatraemia. This can result in serious adverse events, such as cerebral oedema and seizures. The aim of this study was to investigate the incidence of electrolyte disturbance in children when 0.9% saline was the intravenous fluid used in the first 72 h following KT. METHODS: This is a retrospective, observational study of 50 consecutive KT undertaken between January 2017 and January 2019 at a single centre...
January 20, 2022: Pediatric Nephrology
https://read.qxmd.com/read/34969834/sodium-and-water-perturbations-in-patients-who-had-an-acute-stroke-clinical-relevance-and-management-strategies-for-the-neurologist
#27
REVIEW
Kevin C J Yuen, Valerie Sharf, Elizabeth Smith, Minhwan Kim, Alissya S M Yuen, Paul R MacDonald
Sodium and water perturbations, manifesting as hyponatraemia and hypernatraemia, are common in patients who had an acute stroke, and are associated with worse outcomes and increased mortality. Other non-stroke-related causes of sodium and water perturbations in these patients include underlying comorbidities and concomitant medications. Additionally, hospitalised patients who had an acute stroke may receive excessive intravenous hypotonic solutions, have poor fluid intake due to impaired neurocognition and consciousness, may develop sepsis or are administered drugs (eg, mannitol); factors that can further alter serum sodium levels...
June 2022: Stroke and Vascular Neurology
https://read.qxmd.com/read/34866143/approach-to-the-management-of-hypernatraemia-in-older-hospitalised-patients
#28
JOURNAL ARTICLE
M Brennan, L Mulkerrin, S T O'Keeffe, P M O'Shea
Hypernatraemia is associated with high morbidity and mortality and is more common in patients of older age, nursing home residents and those with cognitive impairment and restricted mobility. The most common cause in hospital settings is water dehydration due to reduced intake although other causes should be identified. Once identified, prompt management is necessary to avoid delayed correction as prolonged hypernatremia is associated with increased hospital stay and mortality. Comprehensive history-taking and physical examination, basic investigations and medication review are essential to identify causative and remediable factors in those admitted with hypernatraemia...
2021: Journal of Nutrition, Health & Aging
https://read.qxmd.com/read/34814150/copeptin-utility-in-paediatric-patients-with-hyponatraemia
#29
Rachel L Boal, James Hughes, Debbie Matthews, Helen Johnstone, Christopher Boot, Tim D Cheetham
INTRODUCTION: Copeptin concentrations are a useful component of the diagnostic workup of paediatric patients with polyuria and polydipsia, but the value of measuring copeptin in patients with hyponatraemia is less clear. CASE REPORTS: We report 5 children with hyponatraemia in the context of different underlying pathologies. Copeptin concentrations were elevated in 4 cases (13.7, 14.4, 26.1, and 233 pmol/L; reference range 2.4-8.6 pmol/L), suggesting that non-osmoregulated vasopressin release (syndrome of inappropriate antidiuretic hormone) was the underlying mechanism for low sodium levels...
2022: Hormone Research in Pædiatrics
https://read.qxmd.com/read/34716953/diagnosis-and-management-of-hypernatraemia-in-children
#30
REVIEW
Jakub Zieg
Hypernatraemia is most commonly caused by excessive loss of solute-free water or decreased fluid intake; less often, the aetiology is salt intoxication. Especially infants, young children and individuals with a lack of access to water are at risk of developing hypernatraemia. Diagnosis is based on detailed history, physical examination and basic laboratory tests. Correction of hypernatraemia must be slow to prevent cerebral oedema and irreversible brain damage. This article reviews the aetiology, differential diagnosis and management of conditions associated with paediatric hypernatraemia...
March 2022: Acta Paediatrica
https://read.qxmd.com/read/34603699/hypernatraemia-and-low-egfr-at-hospitalization-in-covid-19-patients-a-deadly-combination
#31
JOURNAL ARTICLE
Elisa Longhitano, Chiara Nardi, Vincenzo Calabrese, Roberta Messina, Giuliana Mazzeo, Emmanuele Venanzi Rullo, Manuela Ceccarelli, Antoine Chatrenet, Patrick Saulnier, Massimo Torreggiani, Giuseppe Nunnari, Giorgina Barbara Piccoli, Domenico Santoro
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on the general population and the burden of pre-existing comorbidities has heavily affected the outcome of the infection. Hyponatraemia has been frequently described. Conversely, hypernatraemia has rarely been described in COVID-19. METHODS: The studied cohort encompasses all COVID-19 patients consecutively admitted to the Messina Hospital, Italy, during the first wave of the epidemic...
October 2021: Clinical Kidney Journal
https://read.qxmd.com/read/34572217/efficacy-and-safety-of-isotonic-and-hypotonic-intravenous-maintenance-fluids-in-hospitalised-children-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#32
JOURNAL ARTICLE
Norfarahin Hasim, Mimi Azliha Abu Bakar, Md Asiful Islam
Hyponatraemia is a known complication in hospitalised children receiving maintenance intravenous fluid. Several studies have been published to investigate the efficacy and safety of intravenous fluids in children. However, there is still an ongoing debate regarding the ideal solution to be used in the paediatric population. Therefore, the aim of this meta-analysis was to investigate the safety and efficacy of administering isotonic versus hypotonic intravenous maintenance fluid in hospitalised children. An extensive search was undertaken on PubMed, Web of Science, Scopus, ScienceDirect, Google Scholar and Cochrane Library on 28 December 2020...
September 8, 2021: Children
https://read.qxmd.com/read/34520642/a-comparison-of-community-acquired-and-hospital-acquired-hypernatraemia-in-patients-who-are-acutely-admitted-to-hospital
#33
JOURNAL ARTICLE
M Brennan, L Mulkerrin, D Wall, P M O' Shea, E C Mulkerrin
Background Hypernatraemia is associated with a short-term mortality of 20-60%. Age-related physiological changes predispose patients to hypernatraemia. This study reviewed acutely admitted patients comparing those with community-acquired (CAH) and hospital-acquired hypernatraemia (HAH). Methods A retrospective study of 102 consecutive acute medical in-patients with serum [Na]>145 mmol/L was conducted. Baseline characteristics, clinical presentation, laboratory values, monitoring, management and outcomes were compared between CAH and HAH groups...
August 19, 2021: Irish Medical Journal
https://read.qxmd.com/read/34401592/poor-haemoglobin-haematocrit-agreement-in-apparently-healthy-adult-population-a-cross-sectional-study-in-cape-coast-metropolis-ghana
#34
JOURNAL ARTICLE
Grace Ali-Baya, Emmanuel Zenile, Bridgette Obuor Aikins, Regina Elorm Amoaning, David Larbi Simpong, Patrick Adu
BACKGROUND: This study estimated total body water (TBW), daily water intake (DWI) and haemoglobin-haematocrit relationship in adults in a tropical environment where active lifestyles could precipitate plasma volume contraction. METHODS: This cross-sectional study recruited 170 participants, and was carried out between February 2018 and May 2018 at University of Cape Coast. Semi-structured questionnaires were used to obtain demographic data and DWI. Five ml of venous blood sample was drawn for full blood count, haemoglobin variant determination, serum sodium and potassium levels...
August 2021: Heliyon
https://read.qxmd.com/read/34370712/management-of-endocrine-disease-dysnatraemia-in-covid-19-prevalence-prognostic-impact-pathophysiology-and-management
#35
REVIEW
Ploutarchos Tzoulis, Ashley B Grossman, Stephanie E Baldeweg, Pierre Bouloux, Gregory Kaltsas
This review examines the prevalence, aetiology, pathophysiology, prognostic value, and investigation of dysnatraemia in hospitalised COVID-19 patients, taking into account all relevant studies published in PubMed and Cochrane Library studies until March 2021. Hyponatraemia is commonly observed in patients with bacterial pneumonia and is an independent predictor for excess mortality and morbidity. However, it remains unknown whether this association applies to coronavirus disease-2019 (COVID-19). Several studies reported a 20-35% prevalence for hyponatraemia and 2-5% for hypernatraemia in patients admitted with COVID-19...
September 6, 2021: European Journal of Endocrinology
https://read.qxmd.com/read/34292875/endocrinology-in-the-time-of-covid-19-2021-updates-the-management-of-diabetes-insipidus-and-hyponatraemia
#36
JOURNAL ARTICLE
Mirjam Christ-Crain, Ewout J Hoorn, Mark Sherlock, Chris J Thompson, John Wass
COVID-19 has changed the nature of medical consultations, emphasizing virtual patient counselling, with relevance for patients with diabetes insipidus (DI) or hyponatraemia. The main complication of desmopressin treatment in DI is dilutional hyponatraemia. Since plasma sodium monitoring is not always possible in times of COVID-19, we recommend to delay the desmopressin dose once a week until aquaresis occurs allowing excess retained water to be excreted. Patients should measure their body weight daily. Patients with DI admitted to the hospital with COVID-19 have a high risk for mortality due to volume depletion...
August 27, 2021: European Journal of Endocrinology
https://read.qxmd.com/read/34158331/type-1-diabetes-mellitus-presenting-with-diabetic-ketoacidosis-in-a-child-with-patau-syndrome-trisomy-13-and-persistent-fetal-haemoglobin
#37
JOURNAL ARTICLE
James Suntac McTaggart, Sindugaa Sivasubramaniam, Rosalyn Jewell, James Yong
A 35-month-old boy with non-mosaic Patau syndrome presented in diabetic ketoacidosis and was diagnosed with type 1 diabetes mellitus. A decision to treat this unanticipated medical problem was made in conjunction with the child's parent, and he improved with fluid resuscitation and insulin treatment. Acute kidney injury with hypernatraemia complicated his treatment, but this resolved with careful intravenous fluid management. The child survived and was followed up in the diabetes clinic where ongoing management was complicated by persistent fetal haemoglobin, which meant that glycated haemoglobin could not be used to gauge his glucose control...
June 22, 2021: BMJ Case Reports
https://read.qxmd.com/read/34052781/early-icu-acquired-hypernatraemia-is-associated-with-injury-severity-and-preceded-by-reduced-renal-sodium-and-chloride-excretion-in-polytrauma-patients
#38
JOURNAL ARTICLE
Christopher Rugg, Mirjam Bachler, Simon Mösenbacher, Elena Wiewiora, Stefan Schmid, Janett Kreutziger, Mathias Ströhle
PURPOSE: To further elucidate the origin of early ICU-acquired hypernatraemia. MATERIAL AND METHODS: In this retrospective single-centre study, polytrauma patients requiring ICU treatment were analysed. RESULTS: Forty-eight (47.5%) of 101 included polytrauma patients developed hypernatraemia within the first 7 days on ICU. They were more severely ill as described by higher SAPS III, ISS, daily SOFA scores and initial norepinephrine requirements as well as longer requirements of mechanical ventilation and ICU treatment in general...
October 2021: Journal of Critical Care
https://read.qxmd.com/read/34041659/diabetes-insipidus-after-endoscopic-transsphenoidal-surgery-multicenter-experience-and-development-of-the-salt-score
#39
MULTICENTER STUDY
Mendel Castle-Kirszbaum, Peter Fuller, Yi Yuen Wang, James King, Tony Goldschlager
OBJECTIVE: To identify risk factors for the development of postoperative diabetes insipidus (DI) in a modern cohort of endoscopic endonasal transsphenoidal surgery. METHODS: Analysis of prospectively collected data of 449 consecutive patients operated on for anterior skull base pathology. DI was defined as a polyuria (> 250 ml/h for ≥ 2 consecutive hours) polydipsia syndrome associated with hypotonic urine with or without hypernatraemia...
December 2021: Pituitary
https://read.qxmd.com/read/34028859/effectiveness-of-dietary-diabetes-insipidus-bundle-on-the-severity-of-postoperative-fluid-imbalance-in-pituitary-region-tumours-a-randomized-controlled-trial
#40
JOURNAL ARTICLE
Hemlata Koundal, Manju Dhandapani, Pratibha Thakur, Pinaki Dutta, Rama Walia, Sushant K Sahoo, Rajesh Chhabra, Sivashanmugam Dhandapani
AIM: To test the effectiveness of nurse-led dietary diabetes insipidus (DI) bundle on the severity of postoperative fluid imbalance in pituitary region tumours. DESIGN: Blinded randomized controlled trial. METHODS: Patients aged 18-65 operated for sellar-suprasellar tumours in an Indian tertiary care centre were enrolled through total enumeration sampling and underwent randomization with allocation concealment during Sep 2018-Feb 2019. Pre-operative DI, postoperative ventilation, renal failure or decompensated diabetes mellitus were excluded...
May 24, 2021: Journal of Advanced Nursing
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