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Hyponatremia and critical illness

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https://www.readbyqxmd.com/read/28535742/electrolyte-disturbances-in-critically-ill-cancer-patients-an-endocrine-perspective
#1
Maryam I Khan, R Phillip Dellinger, Steven G Waguespack
Electrolyte disturbances are frequently encountered in critically ill oncology patients. Hyponatremia and hypernatremia as well as hypocalcemia and hypercalcemia are among the most commonly encountered electrolyte abnormalities. In the intensive care unit, management of critical electrolyte disturbances is focused on initial evaluation and immediate treatment plan to prevent severe complications. A PubMed search was performed to identify best available evidence for evaluation and management of dysnatremias, hypocalcemia, and hypercalcemia...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28478880/neurologic-intensive-care-unit-electrolyte-management
#2
REVIEW
Craig Hutto, Mindy French
Dysnatremia is a common finding in the intensive care unit (ICU) and may be a predictor for mortality and poor clinical outcomes. Depending on the time of onset (ie, on admission vs later in the ICU stay), the incidence of dysnatremias in critically ill patients ranges from 6.9% to 15%, respectively. The symptoms of sodium derangement and their effect on brain physiology make early recognition and correction paramount in the neurologic ICU. Hyponatremia in brain injured patients can lead to life-threatening conditions such as seizures and may worsen cerebral edema and contribute to alterations in intracranial pressure...
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28455602/comparison-of-the-incidences-of-hyponatremia-in-adult-postoperative-critically-ill-patients-receiving-intravenous-maintenance-fluids-with-140%C3%A2-mmol-l-or-35%C3%A2-mmol-l-of-sodium-retrospective-before-after-observational-study
#3
Masako Okada, Moritoki Egi, Yuri Yokota, Naotaka Shirakawa, Daichi Fujimoto, Shinya Taguchi, Nana Furushima, Satoshi Mizobuchi
PURPOSE: The purpose of this study was to compare the incidences of hyponatremia in adult postoperative critically ill patients receiving isotonic and hypotonic maintenance fluids. METHODS: In this single-center retrospective before/after observational study, we included patients who had undergone an elective operation for esophageal cancer or for head and neck cancer and who received postoperative intensive care for >48 h from August 2014 to July 2016. In those patients, sodium-poor solution (35 mmol/L of sodium; Na35) had been administered as maintenance fluid until July 2015...
April 28, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28367176/therapeutic-efficacy-of-nutritional-support-by-percutaneous-endoscopic-gastrostomy-in-critically-ill-patients-a-self-control-clinical-trial
#4
Fei Zhou, Ya-Ling Gao, Zheng-Jin Liu, Yi-Qun Hu
BACKGROUND & OBJECTIVE: Percutaneous endoscopic gastrostomy (PEG) is a procedure to provide enteral nutrition for critically ill patients. It is commonly used in clinical practice; however, the widespread use of PEG is controversial. Our objective was to evaluate the therapeutic effect of nutritional support by PEG in these critically ill patients. METHODS: A total of 64 critically ill patients including 41 males and 23 females (aged 23-84) were identified by the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system during September 2004 to June 2012...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28248872/could-dysnatremias-play-a-role-as-independent-factors-to-predict-mortality-in-surgical-critically-ill-patients
#5
Edson A Nicolini, Roosevelt S Nunes, Gabriela V Santos, Silvana Lia da Silva, Mariana M Carreira, Fernanda G Pellison, Mayra G Menegueti, Maria Auxiliadora-Martins, Fernando Bellissimo-Rodrigues, Marcus A Feres, Anibal Basile-Filho
Several studies have demonstrated the impact of dysnatremias on mortality of intensive care unit (ICU) patients. The objective of this study was to assess whether dysnatremia is an independent factor to predict mortality in surgical critically ill patients admitted to ICU in postoperative phase.One thousand five hundred and ninety-nine surgical patients (58.8% males; mean age of 60.6 ± 14.4 years) admitted to the ICU in the postoperative period were retrospectively studied. The patients were classified according to their serum sodium levels (mmol/L) at admission as normonatremia (135-145), hyponatremia (<135), and hypernatremia (>145)...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28236021/high-incidence-of-cardiac-dysfunction-and-response-to-antiviral-treatment-in-patients-with-chronic-hepatitis-c-virus-infection
#6
Wolfgang Poller, Ziya Kaya, Marion Muche, Mario Kasner, Carsten Skurk, Kai Kappert, Rudolf Tauber, Felicitas Escher, Heinz-Peter Schultheiss, Hans-Jörg Epple, Ulf Landmesser
AIMS: Hepatitis C virus (HCV) has been associated with cardiomyopathies. Former anti-HCV therapies employing interferon could have serious side effects in patients with advanced heart failure since interferon may adversely impact upon cardiac function. We, therefore, examined whether the novel, interferon-free and highly virus-selective anti-HCV combination therapy might be applicable even in advanced or end-stage heart failure. METHODS AND RESULTS: In a retrospective series of HCV-positive patients admitted to our institution with suspected cardiac disease, coronary, valvular or hypertensive heart disease was diagnosed in 70/146 (47...
February 24, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28164835/a-quick-reference-on-hyponatremia
#7
REVIEW
Julien Guillaumin, Stephen P DiBartola
The article focuses on causes of hyponatremia, including hypovolemia, diabetes mellitus and others. Hypovolemia is a major cause of hyponatremia in veterinary medicine. Hypovolemia causes a decrease in effective circulating volume, triggering antidiuretic hormone (ADH) secretion and free water retention, and develops after gastrointestinal losses, renal losses, hemorrhagic shock, hypoadrenocorticism, and other causes of hypovolemia. The article reviews the clinical approach to diagnosing the cause of hyponatremia in critically ill patients, including recognition of the syndrome of inappropriate ADH secretion (SIADH)...
March 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28149085/complications-in-mechanically-ventilated-patients-of-guillain-barre-syndrome-and-their-prognostic-value
#8
Archana Becket Netto, Arun B Taly, Girish B Kulkarni, G S Uma Maheshwara Rao, Shivaji Rao
INTRODUCTION: The spectrum of various complications in critically ill Guillain-Barre syndrome (GBS) and its effect on the prognosis is lacking in literature. This study aimed at enumerating the complications in such a cohort and their significance in the prognosis and mortality. MATERIALS AND METHODS: Retrospective case record analysis of all consecutive mechanically ventilated patients of GBS in neurology Intensive Care Unit (ICU) of a tertiary care institute for 10 years was done...
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28096663/pressure-ulcers-in-palliative-ward-patients-hyponatremia-and-low-blood-pressure-as-indicators-of-risk
#9
Danuta Sternal, Krzysztof Wilczyński, Jan Szewieczek
BACKGROUND: Prevention strategies for pressure ulcer formation remain critical in patients with an advanced illness. We analyzed factors associated with the development of pressure ulcers in patients hospitalized in a palliative care ward setting. PATIENTS AND METHODS: This study was a retrospective analysis of 329 consecutive patients with a mean age (± standard deviation) of 70.4±11.8 years (range: 30-96 years, median 70.0 years; 55.3% women), who were admitted to the Palliative Care Department between July 2012 and May 2014...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28017410/disorders-of-sodium-and-water-homeostasis
#10
REVIEW
Julien Guillaumin, Stephen P DiBartola
This review article discusses normal and abnormal sodium balance in small animals. The terms and concepts central to understanding normal sodium and water balance are presented as well as of the physiology of body fluid compartments and the movement of fluid between those compartments. As dysnatremia is a very common disorder across the spectrum of critically ill patients, the main focus of the article is to present several clinical examples of both acute and chronic hypernatremia and hyponatremia and their practical, clinical management...
March 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27856098/gastric-perforation-and-critical-illness-polyneuropathy-after-steroid-treatment-in-a-patient-with-encephalitis-encephalopathy-with-transient-splenial-lesion
#11
Mitsuru Ikeno, Shinpei Abe, Hirokazu Kurahashi, Michihiko Takasu, Toshiaki Shimizu, Akihisa Okumura
The outcome of mild encephalitis/encephalopathy with reversible splenial lesion (MERS) is favorable whether or not specific treatment is performed. We report a patient with MERS treated with methylprednisolone, complicated by gastric perforation followed by critical illness polyneuropathy. The patient was a 14-year-old male with mildly impaired consciousness and hyponatremia who was treated with methylprednisolone pulse therapy. High fever appeared after methylprednisolone pulse therapy and free air was recognized on an abdomen roentgenogram...
April 2017: Brain & Development
https://www.readbyqxmd.com/read/27826706/clinical-associations-of-early-dysnatremias-in-critically-ill-neonates-and-infants-undergoing-cardiac-surgery
#12
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/27748304/cleistanthus-collinus-poisoning-experience-at-a-medical-intensive-care-unit-in-a-tertiary-care-hospital-in-south-india
#13
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
https://www.readbyqxmd.com/read/27728735/study-of-prevalence-of-hyponatremia-hypomagnesemia-in-critically-ill-icu-treated-patients
#14
Satya Kumar K, Mishra Us, Khatua Cr, Patro D, Arun Sv
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27399058/wernicke-encephalopathy-in-a-patient-with-liver-failure-clinical-case-report
#15
Pan Zhao, Yanling Zhao, Zhenman Wei, Jing Chen, Lilong Yan
Early recognition and diagnosis of Wernicke encephalopathy is pivotal for the prognosis of this medical emergency, especially in patients with liver failure which predisposes individuals to develop hepatic encephalopathy. For these patients, distinguishing between hepatic encephalopathy and Wernicke encephalopathy is a challenge in real-world clinical practice.A male patient with 21-year medical history of liver cirrhosis presented diarrhea and ascites. One month before this visit, he was noted to have poor appetite and progressive fatigue...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27003523/-not-available
#16
REVIEW
Urban Fläring, Kerstin Sandström, Krister Nilsson
Hyponatremia is the most frequent electrolyte abnormality seen postoperatively in pediatric patients receiving maintenance fluid therapy. Hyponatremia is also common in acute pediatric illness. The main factors contributing to hyponatremia in these conditions are increased secretion of antidiuretic hormone (ADH) and routine use of sodium hypotonic fluids. An increased ADH secretion results in an impaired ability to excrete free water. If the sodium concentration falls to less than 125 mmol/L hyponatremic encephalopathy might develop, resulting in cerebral edema...
March 21, 2016: Läkartidningen
https://www.readbyqxmd.com/read/26983857/long-term-changes-in-dysnatremia-incidence-in-the-icu-a-shift-from-hyponatremia-to-hypernatremia
#17
Annemieke Oude Lansink-Hartgring, Lara Hessels, Joachim Weigel, Anne Marie G A de Smet, Diederik Gommers, Prashant V Nannan Panday, Ewout J Hoorn, Maarten W Nijsten
BACKGROUND: Dysnatremia is associated with adverse outcome in critically ill patients. Changes in patients or treatment strategies may have affected the incidence of dysnatremia over time. We investigated long-term changes in the incidence of dysnatremia and analyzed its association with mortality. METHODS: Over a 21-year period (1992-2012), all serum sodium measurements were analyzed retrospectively in two university hospital ICUs, up to day 28 of ICU admission for the presence of dysnatremia...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/26946706/-nephrology-what-s-new-in-2015
#18
Sophie De Seigneux, Patrick Saudan
Isotonic saline and buffered crystalloid solutions may carry an equivalent risk of acute kidney injury in critically ill patients. In hemodialyzed patients, highly dialyzable beta-blockers are less cardioprotective than non-dialyzable beta-blockers, cooling the dialyzate may protect their cerebral white matter and too much parenteral iron may be deleterious. A promising treatment for amyloid deposits is underway. A well tolerated treatment for hyperkalemia has emerged. Low serum magnesium and diminished phosphaturia may be associated with an increased risk of chronic kidney disease...
January 13, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/26886522/clinical-management-of-ebola-virus-disease-in-the-united-states-and-europe
#19
Timothy M Uyeki, Aneesh K Mehta, Richard T Davey, Allison M Liddell, Timo Wolf, Pauline Vetter, Stefan Schmiedel, Thomas Grünewald, Michael Jacobs, Jose R Arribas, Laura Evans, Angela L Hewlett, Arne B Brantsaeter, Giuseppe Ippolito, Christophe Rapp, Andy I M Hoepelman, Julie Gutman
BACKGROUND: Available data on the characteristics of patients with Ebola virus disease (EVD) and clinical management of EVD in settings outside West Africa, as well as the complications observed in those patients, are limited. METHODS: We reviewed available clinical, laboratory, and virologic data from all patients with laboratory-confirmed Ebola virus infection who received care in U.S. and European hospitals from August 2014 through December 2015. RESULTS: A total of 27 patients (median age, 36 years [range, 25 to 75]) with EVD received care; 19 patients (70%) were male, 9 of 26 patients (35%) had coexisting conditions, and 22 (81%) were health care personnel...
February 18, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26767083/are-the-dysnatremias-a-permanent-threat-to-the-critically-ill-patients
#20
Anibal Basile-Filho, Mayra Goncalves Menegueti, Edson Antonio Nicolini, Alessandra Fabiane Lago, Edson Zangiacomi Martinez, Maria Auxiliadora-Martins
BACKGROUD: The dysnatremias (hyponatremia and hypernatremia) are relatively common findings on admission of intensive care unit (ICU) patients and may represent a major risk. The aim of the study was to assess the ability of serum sodium levels and the Acute Physiology and Chronic Health Evaluation II (APACHE II) to predict mortality of surgical critically ill patients. METHODS: One hundred and ninety-five surgical patients (62% males and 38% females; mean age of 51...
February 2016: Journal of Clinical Medicine Research
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