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hypernatremia guidelines

Jennifer Fuchs, Sarah T Adams, Julie Byerley
BACKGROUND: Fluid and electrolyte therapy is an important component in the care of the hospitalized child. Previous pediatric guidelines have followed the Holliday-Segar method of calculating and delivering maintenance IV fluids, using hypotonic fluids in maintenance therapy. However, research demonstrates that hypotonic fluids can lead to iatrogenic hyponatremia and that isotonic fluid is a safer alternative. OBJECTIVE: To provide the ideal approach to intravenous (IV) fluid use in the hospitalized child and determine the safety and effectiveness of isotonic maintenance fluid therapy...
2017: Reviews on Recent Clinical Trials
Ana Gloria Gil, Juan Manuel Irache, Iván Peñuelas, Carlos Javier González Navarro, Adela López de Cerain
In the last years, casein nanoparticles have been proposed as carriers for the oral delivery of biologically active compounds. However, till now, no information about their possible specific hazards in vivo was available. The aim of this work was to assess the safety of casein nanoparticles when administered orally to animals through a 90 days dose-repeated toxicity study (OECD guideline 408), that was performed in Wistar rats under GLP conditions. After 90 days, no evidences of significant alterations in animals treated daily with 50, 150 or 500 mg/kg bw of nanoparticles were found...
August 2017: Food and Chemical Toxicology
Tomoya Okazaki, Toru Hifumi, Kenya Kawakita, Hajime Shishido, Daisuke Ogawa, Masanobu Okauchi, Atsushi Shindo, Masahiko Kawanishi, Takashi Tamiya, Yasuhiro Kuroda
INTRODUCTION: Dysnatremia commonly occur in the intensive care unit (ICU) management of patients with aneurysmal subarachnoid hemorrhage (SAH). However, detailed management strategies have not been provided even by current guidelines. The purposes of this study were to examine the association of abnormal serum sodium levels with unfavorable neurologic outcomes and to identify the target range of serum sodium in patients with SAH. METHODS: We retrospectively reviewed all patients who were consecutively hospitalized with a confirmed diagnosis of SAH between January 2009 and December 2015...
November 2017: Shock
Alireza Soleimani, Fatemeh Foroozanfard, Mohammad Reza Tamadon
Introduction: The most common cause of death from diarrhea is the shock caused by dehydration, electrolytes and acid-base disorders. Objectives: The aim of this study was to evaluate water and electrolytes disorders in diarrhea patients after treating severe acute diarrhea. Patients and Methods: In this study we used a historical cohort and studied patients who were hospitalized due to acute diarrhea and were similarly treated for dehydration and water and electrolyte disorders as recommended by the World Health Organization (WHO) guideline...
2017: Journal of Renal Injury Prevention
N Pertica, L Cicciarella, A Carraro, U Montin, P Violi, A Lupo, G Zaza
BACKGROUND: Acute kidney injury (AKI) after liver transplantation (LT) is a frequent and serious complication. The incidence of AKI requiring continuous renal replacement therapy (CRRT) ranges from 10% to 30%. Kidney Disease: Improving Global Outcomes guidelines indicate the use of citrate as a locoregional anticoagulant drug for CRRT regardless of the patient's hemorrhagic risk. Despite this indication, however, the use of citrate is still under debate in patients with liver failure and/or LT owing to the potential risk of plasmatic citrate accumulation due to reduced liver clearance...
May 2017: Transplantation Proceedings
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
Rosangela Muratori, Andrea Lisotti, Pietro Fusaroli, Alessandra Caponi, Giulia Gibiino, Leonardo Henry Eusebi, Francesco Azzaroli, Nicole Brighi, Guglielmo Altimari, Franco Bazzoli
BACKGROUND: Percutaneous endoscopic gastrostomy is the preferred option for providing enteral nutrition, allowing for an improvement in survival and quality of life. AIM: To evaluate risk factors for early and delayed mortality after gastrostomy placement. METHODS: A single-center retrospective analysis of a prospectively-collected database including all patients undergoing gastrostomy placement for enteral nutrition was performed. Two operators performed all the procedures according to the most recent guidelines...
February 2017: Digestive and Liver Disease
Maulee Hiromi Arambewela, Noel P Somasundaram, Chaminda Garusinghe
BACKGROUND: Hypernatremia is a frequent occurrence among hospitalized patients. Severe hypernatremia is associated with mortality rates of over 60 %. Extreme hypernatremia, defined as sodium levels >190 mmol/l, is a rare occurrence. The literature on electrocardiographic changes occurring with this degree of hypernatremia is extremely scarce. We report the case of an 11-year-old Sri Lankan girl who presented with sodium levels of 226 mmol/l following infusion with 3 % hypertonic saline who developed diffuse QT prolongation leading to fatal ventricular tachycardia...
October 1, 2016: Journal of Medical Case Reports
Amanda E Hagan, Crystal A Farrington, Geoffrey C Wall, Mark M Belz
BACKGROUND: Hyperkalemia is a common problem in hospitalized patients, especially those with underlying chronic kidney disease, but evidence-based guidelines for its treatment are lacking. Sodium polystyrene sulfonate (SPS), a cation exchange resin first approved by the FDA for the treatment of hyperkalemia in 1958, is frequently used alone or in conjunction with other medical therapies to lower serum potassium. Recently, the safety and efficacy of SPS have come into question based on multiple reported cases of bowel necrosis associated with SPS administration...
January 2016: Clinical Nephrology
Thibault Senterre, Ibrahim Abu Zahirah, Catherine Pieltain, Virginie de Halleux, Jacques Rigo
OBJECTIVES: The aim of the present study was to evaluate electrolyte and mineral homeostasis in very-low-birth-weight (VLBW) infants who received high protein and energy intakes with a unique standardized parenteral nutrition solution containing electrolytes and minerals from birth onward. METHODS: Prospective cohort study in 102 infants with birth weight <1250 g. The evolution of plasma biochemical parameters was described during the first 2 weeks of life. RESULTS: During the first 3 days of life, mean parenteral intakes were 51 ± 8 kcal · kg · day with 2...
October 2015: Journal of Pediatric Gastroenterology and Nutrition
J Hensen
The diuretic tolvaptan has been approved for more than 5 years for the indications of euvolemic hyponatremia due to syndrome of inappropriate antidiuretic hormone (SIADH) secretion. In recent years many patients have been treated with tolvaptan and many physicians could gather practical experience. Other countries, such as the USA had already gained greater experience, also in the indications for hypervolemic hyponatremia. After approval was granted more than 5000 patients worldwide were included in the so-called hyponatremia register and 22 active centers in Germany with 317 patients participated...
July 2015: Der Internist
Fenella G Maggs
Hypernatraemia is a common finding among patients presenting to hospital. The aim of this observational study was to discover what types of patients presented with hypernatraemia and whether they were appropriately managed. The management of hypernatraemia was audited against common standards of care. Hypernatraemia at presentation carries a poor prognosis and in this study management of hypernatraemia was found to be done poorly, possibly because for many patients aggressive management was deemed inappropriate...
June 2014: Clinical Medicine: Journal of the Royal College of Physicians of London
Nikolas Deubner, Dominik Berliner, Anna Frey, Gülmisal Güder, Susanne Brenner, Wiebke Fenske, Bruno Allolio, Georg Ertl, Christiane E Angermann, Stefan Störk
AIMS: To investigate in detail the correlates of dysnatremia, and to estimate its differential prognostic relevance in patients with heart failure with reduced or preserved LVEF. Background Hyponatraemia has been shown to carry important prognostic information in patients with heart failure with reduced left ventricular ejection fraction (LVEF). However, exact serum sodium cut-off levels are not defined and the implications for heart failure with preserved ejection fraction (HF-pEF) are unclear...
October 2012: European Journal of Heart Failure
Matthew E Fink
PURPOSE OF REVIEW: Hyperosmolar therapy is one of the core medical treatments for brain edema and intracranial hypertension, but controversy exists regarding the use of the most common agents, mannitol, and hypertonic saline. This article describes the relative merits and adverse effects of these agents using the best available clinical evidence. RECENT FINDINGS: Mannitol is effective and has been used for decades in the treatment of traumatic brain injury, but it may precipitate acute renal failure if serum osmolarity exceeds 320 mOsm/L...
June 2012: Continuum: Lifelong Learning in Neurology
Wendy L Wright
Sodium and fluid management in the brain injured patient directly impacts cerebral edema and cerebral perfusion pressure. Sodium is a major determinant of neuronal size and therefore hyponatremia is aggressively avoided, as hypoosmolar states result in cerebral edema. Negative fluid balance is often avoided because resultant drop in cerebral perfusion pressure can contribute to cerebral ischemia, further inducing secondary neuronal injury. Patients with brain injury are at risk for disorders of sodium and fluid balance (eg, syndrome of inappropriate antidiuresis, cerebral salt wasting, and diabetes insipidus)...
August 2012: Current Neurology and Neuroscience Reports
Harpal Singh, Ankit Parakh, Srikanta Basu, Bimbadarh Rath
UNLABELLED: Plasmodium vivax (Pv) malaria is being increasingly recognized as a cause of severe malaria in children. OBJECTIVES: To describe the various severe manifestations associated with vivax malaria by retrospective analysis of records. METHODS: Children between the ages of 0 and 18 years with a confirmed diagnosis of Pv malaria monoinfection done by peripheral blood film (PBF) and/or rapid diagnostic test (RDT) admitted between June and September 2009 were included...
June 2011: Journal of Infection and Public Health
Hala M Alshayeb, Arif Showkat, Fatima Babar, Therese Mangold, Barry M Wall
INTRODUCTION: Hypernatremia is a common problem in hospitalized patients and is associated with high morbidity and mortality. This study was designed to evaluate whether physicians follow the recommended guidelines for the rate of correction of hypernatremia of ≤0.5 mEq/L/hr and to evaluate the effect of the rate of correction of severe hypernatremia on the mortality of hospitalized patients. METHODS: A retrospective chart review of 131 consecutively hospitalized patients with severe hypernatremia (serum sodium ≥155 mEq/L) was performed...
May 2011: American Journal of the Medical Sciences
Alice J Braga, Amber E R Young
BACKGROUND: The incidence of venous thromboembolic (VTE) events in children has increased in recent years (J Neurosurg, 101, 2004, 32; J Thromb Haemost, 1, 2003, 1443) yet there is currently no consensus as to what VTE prophylaxis, if any, should be applied to the pediatric population. OBJECTIVES/AIMS: Our aim was to audit current practice in pediatric VTE prophylaxis across England and Wales and to advocate simple measures for prevention. We illustrate the importance of the condition with a series of cases from the South West Paediatric Burns and Neurosurgical Services based in Bristol...
April 2011: Paediatric Anaesthesia
Asad E Patanwala, Albert Amini, Brian L Erstad
PURPOSE: The use of hypertonic saline injection in trauma patients is discussed. SUMMARY: Patients with hemorrhage, burns, and traumatic brain injury (TBI) may develop hypovolemic shock and require resuscitation. Compared with conventional isotonic crystalloids, hypertonic saline has several advantages, including hemodynamic, immune-modulating, and antiinflammatory effects, for use in trauma patients for resuscitation. In addition, hypertonic saline is also used in patients with TBI to reduce intracranial pressure (ICP)...
November 15, 2010: American Journal of Health-system Pharmacy: AJHP
Arthur J Siegel, Pierre d'Hemecourt, Marvin M Adner, Terry Shirey, Jeffrey L Brown, Kent B Lewandrowski
Dysnatremia may cause life-threatening encephalopathy in marathon runners. Hypernatremia and exercise-associated hyponatremia (EAH) may manifest with mental status changes and, if untreated, progress to coma and death. We reviewed the on-site blood sodium testing and treatment in collapsed runners at the finish-line medical tent at the Boston marathons from 2001 through 2008. Dysnatremia was diagnosed in 429 (32.5%) of 1,319 collapsed runners. Hypernatremia was present in 366 (27.7%) and hyponatremia in 63 (4...
September 2009: American Journal of Clinical Pathology
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