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Correction for hyponatremia

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https://www.readbyqxmd.com/read/28435905/transurethral-resection-of-the-prostate-bladder-explosion-and-hyponatremic-encephalopathy-a-rare-case-report-of-malpractice
#1
Giuseppe Vacchiano, Aldo Rocca, Rita Compagna, Anna Ginevra Immacolata Zamboli, Vera Cirillo, Lorenza Di Domenico, Veronica Di Nardo, Giuseppe Servillo, Bruno Amato
We present an original case report of a bladder explosion during a TURP intervention for benign prostatic hypertrophy, that was brought on by the absorption of about 5 liters of glycine 1.5% and then onset of a severe hyponatremia. The quick and inappropriate correction of this electrolyte imbalance led the onset of encephalopathy and the death of the patient. The authors discuss the pathogenesis of these uncommon diseases and, considering the most recent Italian Legislation, they highlight the importance to respect good clinical practice standards and guidelines to ensure the most appropriate treatments for the patient and remove any assumptions of medical liability...
January 2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28422408/prevention-of-the-osmotic-demyelination-syndrome-after-liver-transplantation-a-multidisciplinary-perspective
#2
J F Crismale, K A Meliambro, S DeMaria, D B Bronster, S Florman, T D Schiano
The osmotic demyelination syndrome (ODS) is a serious neurologic condition that occurs in the setting of rapid correction of hyponatremia. It presents with protean manifestations, from encephalopathy to the "locked-in" syndrome. ODS can complicate liver transplantation (LT), and its incidence may increase with the inclusion of serum sodium as a factor in the Model for End-Stage Liver Disease score. A comprehensive understanding of risk factors for the development of ODS in the setting of LT, along with recommendations to mitigate the risk of ODS, are necessary...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28419981/thiazide-associated-hyponatremia-report-of-the-hyponatremia-registry-an-observational-multicenter-international-study
#3
Volker Burst, Franziska Grundmann, Torsten Kubacki, Arthur Greenberg, Ingrid Becker, Despina Rudolf, Joseph Verbalis
BACKGROUND: Hyponatremia is a frequent and potentially life-threatening adverse side effect of thiazide diuretics. This sub-analysis of the Hyponatremia Registry database focuses on current management practices of thiazide-associated hyponatremia (TAH) and compares differences between TAH and syndrome of inappropriate antidiuretic hormone secretion (SIADH). METHODS: We analyzed 477 patients from 225 US and EU sites with euvolemic hyponatremia ([Na+] ≤130 mEq/L) who were receiving a thiazide diuretic...
April 19, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28393593/a-study-of-hyponatremia-in-acute-encephalitis-syndrome-a-prospective-study-from-a-tertiary-care-center-in-india
#4
Usha Kant Misra, Jayantee Kalita, Rajesh Kumar Singh, Sanjeev Kumar Bhoi
PURPOSE: To evaluate the frequency and causes of hyponatremia in acute encephalitis syndrome (AES) and its effect on outcome. PATIENTS AND METHODS: Consecutive patients with AES were subjected to neurological evaluation including Glasgow Coma Scale, focal weakness, movement disorder, and reflex changes. The etiology of AES was based on blood and cerebrospinal fluid enzyme-linked immunosorbent assay and polymerase chain reaction. We have categorized patients into neurological or systemic AES...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28356136/efficacy-and-safety-of-rapid-intermittent-correction-compared-with-slow-continuous-correction-with-hypertonic-saline-in-patients-with-moderately-severe-or-severe-symptomatic-hyponatremia-study-protocol-for-a-randomized-controlled-trial-salsa-trial
#5
Anna Lee, You Hwan Jo, Kyuseok Kim, Soyeon Ahn, Yun Kyu Oh, Huijai Lee, Jonghwan Shin, Ho Jun Chin, Ki Young Na, Jung Bok Lee, Seon Ha Baek, Sejoong Kim
BACKGROUND: Hyponatremia is the most common electrolyte imbalance encountered in clinical practice, associated with increased mortality and length of hospital stay. However, no high-quality evidence regarding whether hypertonic saline is best administered as a continuous infusion or a bolus injection has been found to date. Therefore, in the current study, we will evaluate the efficacy and safety of rapid intermittent correction compared with slow continuous correction with hypertonic saline in patients with moderately severe or severe symptomatic hyponatremia...
March 29, 2017: Trials
https://www.readbyqxmd.com/read/28303369/clinical-aspects-of-changes-in-water-and-sodium-homeostasis-in-the-elderly
#6
REVIEW
Christian A Koch, Tibor Fulop
The population of elderly individuals is increasing worldwide. With aging, various hormonal and kidney changes occur, both affecting water homeostasis. Aging is a risk factor for chronic kidney disease (CKD) and many features of CKD are reproduced in the aging kidney. Dehydration and hyperosmolarity can be triggered by diminished thirst perception in this population. Elderly with dementia are especially susceptible to abnormalities of their electrolyte and body water homeostasis and should be (re-)assessed for polypharmacy...
March 2017: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/28295447/effectiveness-and-tolerability-of-conivaptan-and-tolvaptan-for-the-treatment-of-hyponatremia-in-neurocritically-ill-patients
#7
Caroline Der-Nigoghossian, Christine Lesch, Karen Berger
STUDY OBJECTIVE: To describe the effectiveness and tolerability of conivaptan and tolvaptan for the correction of hyponatremia in neurocritically ill patients. DESIGN: Retrospective cohort study. SETTING: Neurointensive care units at two academic medical centers. PATIENTS: Thirty-six adults admitted to the neurocritical care unit who received at least one dose of conivaptan (5 patients) or tolvaptan (31 patients) between June 2012 and May 2013...
March 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28289647/central-pontine-myelinolysis-induced-by-alcohol-withdrawal-a-case-report
#8
Jae Ho Kim, Sae Hyun Kim, Ho Joong Jeong, Young Joo Sim, Dong Kyu Kim, Ghi Chan Kim
Central pontine myelinolysis (CPM) is a demyelinating disorder characterized by the loss of myelin in the center of the basis pons, and is mainly caused by the rapid correction of hyponatremia. We report the case of a young woman who presented with gait disturbance and alcohol withdrawal, and who was eventually diagnosed with CPM. Generally, the cause and pathogenesis of CPM in chronic alcoholics remain unclear. In this cases, the CPM may be unrelated to hyponatremia or its correction. However, it is possible that the osmotic pressure changes due to refeeding syndrome after alcohol withdrawal was the likely cause in this case...
February 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28270885/does-accidental-overcorrection-of-symptomatic-hyponatremia-in-chronic-heart-failure-require-specific-therapeutic-adjustments-for-preventing-central-pontine-myelinolysis
#9
REVIEW
Renato De Vecchis, Michel Noutsias, Carmelina Ariano, Arturo Cesaro, Carmela Cioppa, Anna Giasi, Nicola Maurea
This review aims at summarizing essential aspects of epidemiology and pathophysiology of hyponatremia in chronic heart failure (CHF), to set the ground for a practical as well as evidence-based approach to treatment. As a guide through the discussion of the available evidence, a clinical case of hyponatremia associated with CHF is presented. For this case, the severe neurological signs at presentation justified an emergency treatment with hypertonic saline plus furosemide, as indicated. Subsequently, as the neurological emergency began to subside, the reversion of the trend toward hyponatremia overcorrection was realized by continuous infusion of hypotonic solutions, and administration of desmopressin, so as to prevent the very feared risk of an osmotic demyelination syndrome...
April 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28255808/euvolemic-hyponatremia-in-cancer-patients-report-of-the-hyponatremia-registry-an-observational-multicenter-international-study
#10
Volker Burst, Franziska Grundmann, Torsten Kubacki, Arthur Greenberg, Despina Rudolf, Abdulla Salahudeen, Joseph Verbalis, Christian Grohé
PURPOSE: Hyponatremia secondary to SIADH is frequent in cancer patients and potentially deleterious. The aim of this sub-analysis of the Hyponatremia Registry database is to analyze current diagnostic and therapeutic management practices in cancer patients with SIADH. METHODS: We analyzed 358 cancer patients who had serum sodium concentration ([Na(+)]) ≤ 130 mEq/L and a clinical diagnosis of SIADH from 225 sites in the USA and EU. RESULTS: Precise diagnostic testing was performed in only 46%...
March 2, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28217021/central-pontine-myelinolysis-and-localized-fluorodeoxyglucose-uptake-seen-on-18-f-fdg-pet-ct
#11
Frederik Rønne, Peer Carsten Tfelt-Hansen, Lene Rørdam
Case report describing the finding of central pontine myelinolysis (CPM) using combined fluorine-18 ( (18)F)-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). The patient was a known alcoholic who, during admission was under treatment for hyponatremia, showed a significant decline in both motor and cognitive function. Combined (18)F-FDG PET/CT showed localized FDG uptake in the pons, consistent with the finding of CPM observed on magnetic resonance imaging (MRI). CPM is a demyelinating lesion of the pons, resulting in several neurological symptoms...
January 2017: World Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/28193165/cardiorenal-anemia-syndrome-and-survival-among-heart-failure-patients-in-tanzania-a-prospective-cohort-study
#12
Pedro Pallangyo, Francis Fredrick, Smita Bhalia, Paulina Nicholaus, Peter Kisenge, Benjamin Mtinangi, Mohamed Janabi, Stephen Humphrey
BACKGROUND: Cardiorenal anemia syndrome (CRAS) is an evolving global epidemic associated with increased morbimortality and cost of care. The management of patients with CRAS remains a challenging undertaking worldwide and the lack of evidence-based clinical guidelines adds to the challenge. We aimed to explore the prevalence and survival rates of heart failure patients with CRAS in Tanzania. METHODS: We screened 789 patients and consecutively recruited 463 who met the inclusion criteria...
February 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28160775/craniopharyngioma-presenting-with-severe-hyponatremia-hyponatremia-induced-myopathy-and-panhypopituitarism-a-case-report
#13
M D S A Dilrukshi, G V N Sandakumari, P K Abeysundara, T Chang
BACKGROUND: Craniopharyngiomas are rare intracranial tumors commonly presenting with neurological symptoms. Reports of severe hyponatremia as a presenting manifestation of a craniopharyngioma and hyponatremia-induced myopathy are rare. We report the case of a patient with craniopharyngioma presenting with severe hyponatremia, panhypopituitarism, and hyponatremia-induced myopathy. CASE PRESENTATION: A 52-year-old Sri Lankan man presented with anorexia, nausea, fatigue, generalized muscle weakness, and cramps for 1 week...
February 5, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28149029/efficacy-of-conivaptan-and-hypertonic-3-saline-in-treating-hyponatremia-due-to-syndrome-of-inappropriate-antidiuretic-hormone-in-a-tertiary-intensive-care-unit
#14
Sridhar Nagepalli Venkatarami Reddy, Pradeep Rangappa, Ipe Jacob, Rajeswari Janakiraman, Karthik Rao
BACKGROUND: Hyponatremia is one of the most common electrolyte abnormalities encountered in clinical practice and has a significant impact on morbidity and mortality in hospitalized patients. The optimal management of hyponatremia is still evolving. Over the last decade, vaptans have been increasingly used in clinical practice with promising results. MATERIALS AND METHODS: The study included eighty patients with symptomatic hyponatremia due to syndrome of inappropriate antidiuretic hormone (SIADH) admitted and treated in Intensive Care Unit (ICU) with either conivaptan or hypertonic (3%) saline...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28122966/osmotic-stress-induced-defective-glial-proteostasis-contributes-to-brain-demyelination-after-hyponatremia-treatment
#15
Fabrice Gankam-Kengne, Bruno S Couturier, Alain Soupart, Jean Pierre Brion, Guy Decaux
Adequate protein folding is necessary for normal cell function and a tightly regulated process that requires proper intracellular ionic strength. In many cell types, imbalance between protein synthesis and degradation can induce endoplasmic reticulum (ER) stress, which if sustained, can in turn lead to cell death. In nematodes, osmotic stress induces massive protein aggregation coupled with unfolded protein response and ER stress. In clinical practice, patients sustaining rapid correction of chronic hyponatremia are at risk of osmotic demyelination syndrome...
January 25, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27884088/physiopathology-clinical-diagnosis-and-treatment-of-hyponatremia
#16
REVIEW
Fabrice Gankam Kengne
Hyponatremia is the commonest electrolyte disorder encountered in clinical practice. It develops when the mechanisms regulating water and electrolyte handling are impaired, which in many instances occur in the setting of concurrent diseases such as heart failure, liver failure, renal failure etc… Hyponatremia as an electrolyte disorder has several specificities: when profound it can be quickly fatal and when moderate it carries a high risk of mortality and morbidity, but at the same time incorrect treatment of profound hyponatremia can lead to debilitating neurological disease and it remains unclear if treatment of moderate hyponatremia is associated with a decrease in mortality and morbidity...
December 2016: Acta Clinica Belgica
https://www.readbyqxmd.com/read/27826706/clinical-associations-of-early-dysnatremias-in-critically-ill-neonates-and-infants-undergoing-cardiac-surgery
#17
Jon Kaufman, Daniel Phadke, Suhong Tong, Jennifer Eshelman, Sarah Newman, Christopher Ruzas, Eduardo M da Cruz, Suzanne Osorio
Dysnatremias (DN) are common electrolyte disturbances in cardiac critical illness and are known risk factors for adverse outcomes in certain populations. Little information exists on DN in children with cardiac disease admitted to the cardiac intensive care unit (CICU) after undergoing cardiac surgery, either corrective or palliative. The aim was to determine the incidence and adverse outcomes associated with DN in neonates and infants undergoing cardiac surgery. Retrospective cohort and single center study performed at Children's Hospital Colorado from May 2013 to May 2014, in children under 1 year old admitted to the CICU after undergoing surgery for congenital or acquired cardiac disease...
January 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/27776720/identifying-different-causes-of-hyponatremia-with-fractional-excretion-of-uric-acid
#18
Louis J Imbriano, Joseph Mattana, James Drakakis, John K Maesaka
BACKGROUND: There is controversy over the prevalence of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and cerebral or renal salt wasting (RSW), 2 syndromes with identical common clinical and laboratory parameters but different therapies. The traditional approach to the hyponatremic patient relies on volume assessment, but there are limitations to this method. METHODS: We used an algorithm that relies on fractional excretion of urate (FEurate) to evaluate patients with hyponatremia and present 4 illustrative cases...
October 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27766511/the-efficacy-and-safety-of-tolvaptan-in-patients-with-hyponatremia-a-meta-analysis-of-randomized-controlled-trials
#19
REVIEW
Benlei Li, Dong Fang, Cheng Qian, Hongliang Feng, Yanggan Wang
BACKGROUND AND OBJECTIVES: Comprehensive evaluations regarding the benefits of tolvaptan in the treatment of hyponatremia are lacking. The objective of this meta-analysis was to assess the efficacy and safety of tolvaptan in patients with hyponatremia. METHODS: Pertinent studies were identified by searching PubMed, EMBASE, Web of Science, and the Cochrane Library for articles published between their respective inception dates and 31 April 2016. Summary relative risks (RRs) or weighted mean differences (WMDs) with their 95 % confidence intervals (CIs) were calculated using fixed-effects or randomized-effects models, depending on the degree of heterogeneity noted among the studies included in the analysis...
April 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27748304/cleistanthus-collinus-poisoning-experience-at-a-medical-intensive-care-unit-in-a-tertiary-care-hospital-in-south-india
#20
Alladi Mohan, G Sivaram Naik, J Harikrishna, D Prabath Kumar, M H Rao, Kvs Sarma, K K Guntupalli
BACKGROUND & OBJECTIVES: Ingestion of Cleistanthus collinus causes hypokalemia and cardiac arrhythmias leading to mortality in most cases. We undertook this retrospective study to evaluate the clinical presentation and predictors of outcome in critically ill patients admitted with C. collinus poisoning. METHODS: The case records of 56 patients admitted to the medical intensive care unit (MICU) of a tertiary care teaching hospital in south India (2000-2014) with C...
June 2016: Indian Journal of Medical Research
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