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Hypernatremia treatment

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https://www.readbyqxmd.com/read/27876158/is-bicarbonate-therapy-useful
#1
REVIEW
Kate Hopper
Despite concerns about the negative effects of metabolic acidosis, there is minimal evidence that sodium bicarbonate administration is an effective treatment. In addition, sodium bicarbonate therapy is associated with many adverse effects, including paradoxic intracellular acidosis, hypokalemia, hypocalcemia, hypernatremia, and hyperosmolality. Definitive recommendations regarding bicarbonate therapy are challenging as there is little high-quality evidence available. In most clinical scenarios of metabolic acidosis, treatment efforts should focus on resolution of the underlying cause, and sodium bicarbonate therapy should be used with caution, if at all...
November 18, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27858393/the-clinical-predictors-of-shunt-dependent-hydrocephalus-following-aneurysmal-subarachnoid-hemorrhage
#2
Sio Iong Chang, David Hung-Tsang Yen, Ming Dar Tsai, Cheng-Ta Hsieh
AIM: Shunt-dependent hydrocephalus (SDH) is a relatively common complication following aneurysmal subarachnoid hemorrhage (aSAH). Delay in diagnosis and treatment may worsen neurological outcome. This study was conducted to identify early clinical factors associated with SDH following aSAH. MATERIAL AND METHODS: Patients diagnosed with aSAH at our hospital from January 2010 through July 2014 were included. Patients aged ≤ 18 or ≥ 90 year, with concurrent arteriovenous malformation, treated with both clipping and coiling, or not receiving definitive treatment were excluded...
October 17, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27845813/hypernatremi-%C3%A2-vanligt-tillst%C3%A3-nd-vid-kritisk-sjukdom-associerat-med-h%C3%A3-g-mortalitet-men-behandlingsarsenalen-%C3%A3-r-otillr%C3%A3-cklig
#3
Karin Strand, Hans Barle
Hypernatremia in ICU is common, both as a preexisting condition and acquired during intensive care. Hypernatremia increases mortality and morbidity as an increased length of a stay and increased risk of complications. Current treatment options of manifest hypernatremia are limited, but there are opportunities for prevention that should not be overlooked.
November 14, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27826706/clinical-associations-of-early-dysnatremias-in-critically-ill-neonates-and-infants-undergoing-cardiac-surgery
#4
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...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27652275/unusual-presentation-of-central-diabetes-insipidus-in-a-patient-with-neurosarcoidosis
#5
Vedha Sanghi, Aanchal Kapoor
Hypernatremia is a frequent cause of intensive care unit admission. The patient presented in this article had hypernatremia refractory to D5W (dextrose 5% water) therapy, which led to a complex investigation. Workup revealed central diabetes insipidus most likely secondary to flare up of neurosarcoidosis. The challenge in terms of diagnosis was a presentation with low urine output in the setting of hypernatremia resistant to treatment with desmopressin. This case unfolded the role of hypothyroidism causing secondary renal dysfunction and hence needed continued treatment with thyroxine in addition to treatment for hypernatremia...
July 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27650232/the-reduction-rate-of-serum-sodium-and-mortality-in-patients-undergoing-continuous-venovenous-hemofiltration-for-acute-severe-hypernatremia
#6
Feng Ma, Yirong Liu, Ming Bai, Yangping Li, Yan Yu, Meilan Zhou, Pengbo Wang, Lijie He, Chen Huang, Hanmin Wang, Shiren Sun
BACKGROUND: The excessive correction of acute hypernatremia is not known to be harmful. This study aimed to evaluate whether a reduction rate of serum sodium (RRSeNa) > 1mEq/L/hour in acute severe hypernatremia is an independent risk factor for mortality in critically ill patients undergoing continuous venovenous hemofiltration (CVVH) treatment. MATERIALS AND METHODS: For this retrospective study, we reviewed records of 75 critically ill patients undergoing CVVH treatment for acute severe hypernatremia between March 2011 and March 2015...
September 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27642476/-hemolytic-uremic-syndrome-hus-in-children-at-the-university-hospital-center-in-dakar-about-four-cases
#7
Aliou Thiongane, Aliou Abdoulaye Ndongo, Idrissa Demba Ba, Djibril Boiro, Papa Moctar Faye, Younoussa Keita, Aïssatou Ba, Djeynaba Fafa Cissé, Idrissa Basse, Lamine Thiam, Indou Déme Ly, Babacar Niang, Abou Ba, Amadou Lamine Fall, Saliou Diouf, Ousmane Ndiaye, Mamadou Ba, Mamadou Sarr
Hemolytic-uremic syndrome (HUS) is a common cause of organic acute renal failure (ARF) in children. It is a progressive complication of acute gastroenteritis (AGE), especially caused by Escherichia coli in children. This study aimed to describe the clinical, therapeutic and evolutionary aspects of this affection in four children. We collected four cases of HUS. The average age was 10,5 months (5-15mois), exclusively boys. Clinical examination revealed a hemolytic anemia (pallor and jaundice), oligoanuria and edematous syndrome (2 cases), arterial hypertension (1 patient), AGE associated with severe dehydration and hypovolemic shock (2 patients), consciousness disorders...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27583842/prognostic-value-of-icu-acquired-hypernatremia-in-patients-with-neurological-dysfunction
#8
Bei Hu, Qianpeng Han, Nashun Mengke, Kairan He, Yiqin Zhang, Zhiqiang Nie, Hongke Zeng
Many studies have indicated that hypernatremia is associated with increased mortality. In this study, we aimed to explore the relationship between intensive care unit (ICU)-acquired hypernatremia and the prognosis of critically neurological patients.Based on serum sodium level in the ICU, 450 patients were divided into 3 groups: 222 had normal serum sodium, 142 had mild hypernatremia, and 86 had severe hypernatremia. Kaplan-Meier and multivariable binary logistic regression analyses were performed to evaluate the prognostic value of hypernatremia in critically neurological patients...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27471737/suitable-intravenous-fluid-for-preventing-dysnatremia-in-children-with-gastroenteritis-a-randomized-clinical-trial
#9
Kioomars Golshekan, Hamidreza Badeli, Mahboube Miri, Maryam Mirzaie, Afagh Hassanzadeh Rad, Fatemeh Salamat, Sepideh Abdi Tazeabadi, Nahid Bidar, Kobra Blouki-Moghaddam, Houman Hashemian
INTRODUCTION: Gastroenteritis (GE) is one of the most common pediatric diseases. Hyponatremia commonly occurs by administering hypotonic fluids to GE and hospitalized children. Yet, there is no consensus on the ideal method of treatment. OBJECTIVES: we aimed to assess suitable intravenous (IV) fluid for preventing dysnatremia in children with GE. PATIENTS AND METHODS: This is a double blind randomized clinical trial, which was conducted on infants of 6 months up to 14 years children with GE...
2016: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/27463219/extrapontine-myelinolysis-associated-with-severe-hypernatremia-in-infancy
#10
Ryoji Aoki, Tetsuji Morimoto, Yuno Takahashi, Hiroshi Saito, Tatsuo Fuchigami, Shori Takahashi
Extrapontine myelinolysis (EPM) is an uncommon disorder in children, with few pediatric cases reported to date. We report the first case of an infant with EPM without central pontine myelinolysis (CPM) presenting with severe hypernatremia. On admission, the infant had impaired consciousness, mild dehydration, and severe hypernatremia (190 mmol/L). The following day, the patient developed abnormal involuntary movements. Brain magnetic resonance imaging (MRI) confirmed EPM without CPM. He recovered without sequelae, and clinical examinations were within normal limits approximately 6 months after discharge...
September 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27424129/prognostic-factors-of-early-outcome-and-discharge-status-in-patients-undergoing-surgical-intervention-following-traumatic-intracranial-hemorrhage
#11
Tatsuhiro Fujii, Gabriela Moriel, Daniel R Kramer, Frank Attenello, Gabriel Zada
Over the past several decades, the rate of traumatic brain injury (TBI)-related emergency room visits in the United States has steadily increased, yet mortality in these patients has decreased. This improvement in outcome is largely due to advances in prehospital care, intensive care unit management, and the effectiveness of neurosurgical procedures, such as decompressive craniectomies. It is imperative to identify clinical factors predictive of patients who benefit from early mobilization of resources and operative treatment...
September 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27395406/risk-factors-for-hypernatremia-in-patients-with-short-and-long-term-tolvaptan-treatment
#12
Keita Hirai, Tatsuki Shimomura, Hideaki Moriwaki, Hidetoshi Ishii, Takayuki Shimoshikiryo, Daiki Tsuji, Kazuyuki Inoue, Toshihiko Kadoiri, Kunihiko Itoh
PURPOSE: The long-term efficacy of tolvaptan, a vasopressin V2 receptor antagonist, has been reported. However, the safety of long-term treatment remains to be fully elucidated. We assessed the safety profile of tolvaptan with respect to hypernatremia. METHODS: This retrospective study included 371 patients treated with tolvaptan. Risk factors for hypernatremia (serum sodium concentration ≥147 mEq/L) were determined. RESULTS: Hypernatremia occurred in 95 patients (25...
October 2016: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27346973/pseudohypernatremia-secondary-to-trisodium-citrate-citra-locktm
#13
Janice Milliere, Daryl Corriveau, Malvinder S Parmar
INTRODUCTION: Hypernatremia is common among hospitalized patients especially in the intensive care units and presents an independent risk factor for mortality. Mild hypernatremia is often asymptomatic but severe hypernatremia causes central nervous system dysfunction with initial non-specific symptoms of encephalopathy that may progress to seizures, coma and death, if left untreated. Severe hypernatremia is a medical emergency and requires emergent medical attention. MATERIALS AND METHODS: A haemodialysis patient who arrived for his scheduled haemodialysis treatment had monthly blood work drawn and was reported to have severe hypernatremia with serum sodium concentration of 183 mmol/L...
2016: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/27335281/hypernatremia-induced-vasopressin-secretion-is-not-altered-in-trpv1-rats
#14
Andrew Blake Tucker, Sean D Stocker
Changes in osmolality or extracellular NaCl concentrations are detected by specialized neurons in the hypothalamus to increase vasopressin (VP) and stimulate thirst. Recent in vitro evidence suggests this process is mediated by an NH2-terminal variant of the transient receptor potential vanilloid type 1 (TRPV1) channel expressed by osmosensitive neurons of the lamina terminalis and vasopressinergic neurons of the supraoptic nucleus. The present study tested this hypothesis in vivo by analysis of plasma VP levels during acute hypernatremia in awake control and TRPV1(-/-) rats...
September 1, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/27213601/-hypernatremia-diagnostics-and-therapy
#15
Christian Arndt, Hinnerk Wulf
Hypernatremia is a common electrolyte disorder that reflects an imbalance in the water balance of the body, often resulting from an increased loss of free water compared to sodium excretion. It is rarely based on excessive sodium intake. The clinical presentation is often characterized by a central nervous system dysfunction (confusion, coma) and pronounced thirst (in awake patients). In addition to medical history, the volume status of the patient and the osmolality of urine are leading in the differential diagnosis...
May 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27156758/diagnosis-and-treatment-of-hypernatremia
#16
REVIEW
Saif A Muhsin, David B Mount
Hypernatremia is defined as a serum sodium level above 145 mmol/L. It is a frequently encountered electrolyte disturbance in the hospital setting, with an unappreciated high mortality. Understanding hypernatremia requires a comprehension of body fluid compartments, as well as concepts of the preservation of normal body water balance. The human body maintains a normal osmolality between 280 and 295 mOsm/kg via Arginine Vasopressin (AVP), thirst, and the renal response to AVP; dysfunction of all three of these factors can cause hypernatremia...
March 2016: Best Practice & Research. Clinical Endocrinology & Metabolism
https://www.readbyqxmd.com/read/27098904/a-case-of-myeloperoxidase-anti-neutrophil-cytoplasmic-antibody-mpo-anca-associated-hypertrophic-pachymeningitis-presenting-with-multiple-cranial-nerve-palsies-and-diabetes-insipidus
#17
Ken Yasuda, Makoto Sainouchi, Masahiro Goto, Nagako Murase, Ryo Ohtani, Michikazu Nakamura
A 61-year-old woman developed hearing difficulties and became thirsty after experiencing cold symptoms. A neurological examination revealed a loss of odor sensation, facial palsy, dysphasia, and dysarthria. Vocal cord palsy was observed during pharyngoscopy. Brain magnetic resonance imaging (MRI) showed a thickened pituitary stalk and swelling of the pituitary gland, but no high signal intensity regions were seen in the posterior portion of the pituitary gland. Gadolinium-enhanced MRI demonstrated a thickened dura mater over the anterior cranial fossa...
May 31, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/27082573/efficacy-and-safety-of-vasopressin-receptor-antagonists-for-euvolemic-or-hypervolemic-hyponatremia-a-meta-analysis
#18
REVIEW
Xiangyun Zhang, Mingyi Zhao, Wei Du, Dongni Zu, Yingwei Sun, Rongwu Xiang, Jingyu Yang
Hyponatremia, defined as a nonartifactual serum sodium level <135 mmol/L, is the most common fluid and electrolyte abnormality in clinical practice. Traditional managements (fluid restriction, hypertonic saline and loop diuretics, etc.) are difficult to maintain or ineffective. Recently, vasopressin receptor antagonists (VRAs) have shown promise for the treatment of hyponatremia. We aimed to conduct a meta-analysis to evaluate the efficacy and safety of VRAs in patients with euvolemic or hypervolemic hyponatremia...
April 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27042416/comatose-and-noncomatose-adult-diabetic-ketoacidosis-patients-at-the-university-teaching-hospital-zambia-clinical-profiles-risk-factors-and-mortality-outcomes
#19
Mwanja Kakusa, Brown Kamanga, Owen Ngalamika, Soka Nyirenda
BACKGROUND: Diabetic ketoacidosis (DKA) is one of the commonly encountered diabetes mellitus emergencies. AIM: This study aimed at describing the clinical profiles and hospitalization outcomes of DKA patients at the University Teaching Hospital (UTH) in Lusaka, Zambia and to investigate the role of coma on mortality outcome. MATERIALS AND METHODS: This was a cross-sectional analytical study of hospitalized DKA patients at UTH. The data collected included clinical presentation, precipitating factors, laboratory profiles, complications, and hospitalization outcomes...
March 2016: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27037930/the-changing-role-of-sodium-management-in-cirrhosis
#20
REVIEW
Blanca Lizaola, Alan Bonder, Elliot B Tapper, Angela Mendez-Bocanegra, Andres Cardenas
Hyponatremia may occur in patients with cirrhosis and ascites mainly due to water retention and an inability of the kidney to excrete free water. The main reason for this abnormality is related to the fact that these patients have portal hypertension and this leads to systemic vasodilation that in turn activates sodium-retaining and water-retaining systems such as the renin-angiotensin-aldosterone system and arginine vasopressin (AVP). AVP increases solute-free water retention by acting on the V2 receptors of the kidney-collecting tubes...
June 2016: Current Treatment Options in Gastroenterology
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