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"Hypernatraemia" OR "Hypernatremia" AND "Treatment"

Vera Spatenkova, Ondrej Bradac, Patricia de Lacy, Pavel Skrabalek
INTRODUCTION: Polyuria has the potential to cause severe water and sodium imbalance. We studied the epidemiology of polyuria in association with dysnatraemias and whether polyuria is an independent risk factor for higher mortality and poorer outcome in neurocritical care. METHODS: We performed an analysis of a 3-year prospective database containing 902 neurocritical care patients. Polyuria was defined as diuresis above 4000 ml/day, hyponatraemia as a serum sodium (SeNa) < 135 mmol/l and hypernatraemia as SeNa > 150 mmol/l...
2015: British Journal of Neurosurgery
L A Behan, M Sherlock, P Moyles, O Renshaw, C J T Thompson, C Orr, K Holte, M R Salehmohamed, N Glynn, W Tormey, C J Thompson
CONTEXT AND OBJECTIVE: Patients with cranial diabetes insipidus (CDI) are at risk of developing both hypernatraemia and hyponatraemia, due to the condition itself or secondary to treatment with vasopressin-analogues or during administration of i.v. fluids. We aimed to assess the frequency and impact of dysnatraemias in the inpatient (INPT) and outpatient (OPT) setting in desmopressin-treated CDI, comparing those with normal thirst with those with abnormal thirst. DESIGN: The study included 192 patients with cranial diabetes, who were identified from the Beaumont Pituitary Database, a tertiary referral centre...
March 2015: European Journal of Endocrinology
Helene Korvenius Jørgensen, Anne Cathrine Haug, Torben Gilsaa
Hypernatraemia is a common and potentially serious condition in the intensive care unit (ICU). We present a case, a 84-year-old man, who was admitted to the ICU with septic shock due to pneumonia. After successful fluid resuscitation and antibiotic treatment the patient was stable, but severely oedematose and developed hypernatraemia (S-Na 165 mmol/l) with cerebral symptoms. Urine-Na was very low. The condition was successfully treated with continuous veno-venous haemodialysis (CVVHD), adding extra Na to the dialysate in order to correct the hypernatraemia at a rate of 8-15 mmol/l per day...
September 23, 2013: Ugeskrift for Laeger
Christian Overgaard-Steensen, Troels Ring
Disturbances in sodium concentration are common in the critically ill patient and associated with increased mortality. The key principle in treatment and prevention is that plasma [Na+] (P-[Na+]) is determined by external water and cation balances. P-[Na+] determines plasma tonicity. An important exception is hyperglycaemia, where P-[Na+] may be reduced despite plasma hypertonicity. The patient is first treated to secure airway, breathing and circulation to diminish secondary organ damage. Symptoms are critical when handling a patient with hyponatraemia...
February 27, 2013: Critical Care: the Official Journal of the Critical Care Forum
Soham Rej, Soumia I Senouci, Karl Looper, Marilyn Segal
BACKGROUND: Diabetes insipidus (DI) is a recognized adverse effect of lithium use, and studies have shown an association between decreased renal function and DI in patients using lithium. We hypothesize that hypernatraemic events that occur in DI predict decreased renal function in elderly patients on lithium. METHODS: We conducted a retrospective cohort study involving 55 geriatric psychiatry patients using lithium between 1985 and 2010. Patients who always had sodium levels ≤146 mmol/L were compared to patients with one or more episodes of hypernatraemia (serum sodium level ≥147 mmol/L) for estimated glomerular filtration rate (eGFR) levels and prevalence of severe chronic renal failure (eGFR ≤30 mL/min/1...
March 2013: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Sam Joseph Oddie, Vanessa Craven, Kathryn Deakin, Janette Westman, Andrew Scally
AIMS: To describe incidence, presentation, treatment and short term outcomes of severe neonatal hypernatraemia (SNH, sodium ≥160 mmol/l). METHODS: Prospective, population based surveillance study over 13 months using the British Paediatric Surveillance Unit. Cases were >33 weeks gestation at birth, fed breast or formula milk and <28 days of age at presentation. RESULTS: Of 62 cases of SNH reported (7, 95% CI 5.4 to 9.0 per 1 00 000 live births), 61 mothers had intended to achieve exclusive breast feeding...
September 2013: Archives of Disease in Childhood. Fetal and Neonatal Edition
Mohammod J Chisti, Mark A C Pietroni, Mohammad Samsul Alom, Jonathan Harvey Smith
A boy aged 4 months 7 days was admitted to the Intensive Care Unit (ICU) of the Dhaka Hospital of icddr,b, Dhaka, Bangladesh, with the problems of acute watery diarrhoea with some dehydration, pneumonia, lethargy, and hypernatraemia (serum sodium of 201 mmol/L). Correction for hypernatraemia was tried by using only oral rehydration salt (ORS) solution. Seizures occurred during correction of the hypernatraemia. These were difficult to control and required three doses of injection lorazepam, a loading dose of injection phenobarbitone, followed by injection phenytoin and finally two doses of injection mannitol (even though there was no clinical or imaging evidence by ultrasonography or computed tomography of cerebral oedema)...
September 2012: Journal of Health, Population, and Nutrition
Mohamed Osama Hegazi, Anant Mashankar
OBJECTIVE: To report a rare association of central pontine myelinolysis (CPM) with hyperosmolar hyperglycaemic state (HHS). CLINICAL PRESENTATION AND INTERVENTION: A diabetic female presented with HHS and prolonged severe hypernatraemia. The metabolic derangement was adequately treated with proper correction of both hyperglycaemia and hypernatraemia. Lack of improvement in the presenting confusional state and the development of a fresh neurological deterioration led to the suspicion of CPM that was confirmed with magnetic resonance imaging...
2013: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Almudena Moreno Elola-Olaso, Daniel L Davenport, Jonathan C Hundley, Michael F Daily, Roberto Gedaly
BACKGROUND:   Postoperative infections are frequent complications after liver resection and have significant impact on length of stay, morbidity and mortality. Surgical site infection (SSI) is the most common nosocomial infection in surgical patients, accounting for 38% of all such infections. OBJECTIVES:   This study aimed to identify predictors of SSI and organ space SSI after liver resection. METHODS:   Data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for patients who underwent liver resection in 2005, 2006 or 2007 in any of 173 hospitals throughout the USA were analysed...
February 2012: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Manolis Michalodimitrakis, Despoina Nathena, Anna Mavroforou, Asteria Papavdi, Elena F Kranioti
A case of fatal hypernatraemia after laparoscopic treatment of hydatid livers cysts is presented in order to highlight the risks associated with the implementation of newer techniques and the use of hypertonic saline as a scolecocidal agent in hydatid disease. Additionally this case raises some concerns on the importance of obtaining a patient's informed consent.
June 10, 2012: Forensic Science International
Chengqing Fang, Jianhua Mao, Yuwen Dai, Yonghui Xia, Haidong Fu, Yifang Chen, Yaping Wang, Aimin Liu
AIM: To compare the fluid management of hypernatraemic dehydration in acute gastroenteritis in those who developed cerebral oedema (cases) versus those who did not (controls). METHODS: A retrospective study of 97 cases of hypernatraemic dehydration at a tertiary children's hospital in China over five years, in which rehydration regimes of 49 children who developed cerebral oedema were compared with 48 children who made an uneventful recovery. RESULTS: Risk factors for cerebral oedema (vs...
June 2010: Journal of Paediatrics and Child Health
Michael Darmon, Jean-François Timsit, Adrien Francais, Molière Nguile-Makao, Christophe Adrie, Yves Cohen, Maïté Garrouste-Orgeas, Dany Goldgran-Toledano, Anne-Sylvie Dumenil, Samir Jamali, Christine Cheval, Bernard Allaouchiche, Bertrand Souweine, Elie Azoulay
BACKGROUND: The aim of this study is to describe the prevalence and outcomes of intensive care unit (ICU)-acquired hypernatraemia (IAH). METHODS: A retrospective analysis was performed on a prospectively collected database fed by 12 ICUs. Subjects are unselected patients with ICU stay >48 h. Mild and moderate to severe hypernatraemia were defined as serum sodium >145 and >150 mmol/L, respectively. IAH was hypernatraemia occurring >or=24 h after ICU admission in patients with normal serum sodium at ICU admission...
August 2010: Nephrology, Dialysis, Transplantation
S D O'Donoghue, J M Dulhunty, H K Bandeshe, S Senthuran, J R Gowardman
This study reports the incidence and associated mortality of acquired hypernatraemia (Na > 150 mmol x l(-1)) in a general medical/surgical intensive care unit. Patients admitted over a 5-year period with normal sodium values were eligible for inclusion; exclusions were made for burn/neurosurgical diagnoses and for hypertonic saline therapy. From 3475 admissions (3317 patients), 266 (7.7%) episodes of hypernatraemia were observed. Hospital mortality was 33.5% in the hypernatraemic group and 7.7% in the normonatraemic group (p < 0...
May 2009: Anaesthesia
Yogesh Apte, Rinaldo Bellomo, Stephen Warrillow, Donna Goldsmith, Michael Gillies, Forbes McGain
BACKGROUND: Hypernatraemia may develop during intravenous infusion of frusemide. Spironolactone is an aldosterone antagonist that promotes natriuresis and may attenuate such hypernatraemia, but its effect in this setting has not been previously studied. OBJECTIVE: To assess whether the administration of spironolactone to ventilated patients receiving a frusemide infusion attenuates the increase in serum sodium concentration. DESIGN AND SETTING: Randomised, double-blind, placebo-controlled trial (January 2005 to December 2006)...
December 2008: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Minhtri K Nguyen, Ira Kurtz
BACKGROUND: Hypervolemic hypernatremia is caused by an increase in total exchangeable Na(+) and K(+) in excess of an increment in total body H(2)O (TBW). Unlike patients with hypovolemic or euvolemic hypernatremia, treatment needs to be targeted at correcting not only the elevated plasma Na(+) concentration, but also there is an additional requirement to achieve negative H(2)O balance to correct the increment in TBW. METHODS: Correction of hypervolemic hypernatremia can be attained by ensuring that the negative Na(+) and K(+) balance exceeds the negative H(2)O balance...
July 2008: Nephrology, Dialysis, Transplantation
Jinny Jeffery, Ruth M Ayling, Richard J S McGonigle
Hypernatraemia over 160 mmol/L is considered to be severe. This case reports a patient who developed extreme hypernatraemia with a serum sodium concentration of 196 mmol/L. The patient was known to have chronic renal impairment and was admitted with acute deterioration of renal function secondary to dehydration. This was considered to be secondary to poor oral fluid intake (related to depression) and lithium-induced nephrogenic diabetes insipidus with salt-losing nephropathy. The patient had a high urinary sodium excretion but was also in a pure water losing state as evidenced by an inappropriately low urine osmolality for the plasma osmolality and was successfully treated with hypotonic intravenous fluid and desmopressin...
September 2007: Annals of Clinical Biochemistry
Gillian Robertson, Michelle Carrihill, Mark Hatherill, Zainab Waggie, Louis Reynolds, Andrew Argent
OBJECTIVE: To describe the relationship between fluid management, serum sodium and outcome in critically ill children with hypernatraemic gastroenteritis. METHODS: A retrospective study of 57 children with hypernatraemic gastroenteritis admitted to a paediatric intensive care unit in Cape Town, South Africa. Data were collected on fluid management, serum electrolytes and adverse outcome (seizures, new neurological deficit and mortality) and analysed using univariate and multivariate statistics...
April 2007: Journal of Paediatrics and Child Health
George Liamis, Michalis Kalogirou, Vasilios Saugos, Moses Elisaf
BACKGROUND: Rapid correction of dysnatraemias is frequently associated with increased morbidity and mortality. Therefore, it is important to estimate the proper volume and type of infusate required to change the serum sodium concentration predictably. The aim of this study is to evaluate the utility or/and the accuracy of the Adrogue-Madias formula in managing patients with hyponatraemia and hypernatraemia. METHODS: Among the 317 patients who either on admission to our internal medicine clinic or during their hospitalization were found to have hyponatraemia or hypernatraemia, we studied 189 patients (59...
June 2006: Nephrology, Dialysis, Transplantation
Y Ofran, D Lavi, D Opher, T A Weiss, E Elinav
Excessive ingestion of salt is a well-recognized cause of hypernatraemia in children, is uncommonly recognized in debilitated elderly persons, but is rarely diagnosed in healthy, independent adults. We report a case of fatal salt poisoning in a 20-year-old lady who suffered of post-natal depression and ingested large quantities of salt as part of exorcism ritual. She presented with the highest ever documented serum sodium level of 255 mmol L(-1), associated with severe neurological impairment that was unresponsive to aggressive hypotonic fluid replacement...
December 2004: Journal of Internal Medicine
Noha R Barsoum, Barton S Levine
Hypo- and hypernatraemic (dysnatraemic) disorders are among the most common electrolyte disorders encountered by primary care providers and nephrologists. They represent a diagnostic and therapeutic challenge, and inappropriate management can result in serious sequelae. Several formulas addressing the fluid prescription for dysnatraemic patients have been introduced. Many authors stress the importance of considering output as well as input in formulating a treatment plan for the dysnatraemic patient. However, currently available formulas fail to account for ongoing renal and extrarenal fluid and electrolyte losses...
July 2002: Nephrology, Dialysis, Transplantation
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