Hypernatremia is a common electrolyte disorder in patients with brain injury. The mortality of brain injury patients with severe hypernatremia may be as high as 86.8%. The efficacy of conventional treatment for hypernatremia is limited. Continuous renal replacement therapy (CRRT) can slowly, controllably, and continuously reduce the blood sodium concentration and gradually become an important treatment for severe hypernatremia patients. This review aims to provide important information for clinicians and clinical researchers by describing the etiology, diagnosis, hazards, conventional treatment, and CRRT treatment of hypernatremia in patients with traumatic brain injury.
Background: Continue renal replacement therapy (CRRT) is commonly employed for rhabdomyolysis (RM) patients. However, the optimal initiation timing of CRRT and prognostic factors were not well evaluated for patients with RM. We aimed to investigate the efficacy of CRRT timing on mortality and the risk factors of death in RM patients who accepted CRRT.Methods: RM patients who received CRRT between May 2010 and May 2021 in our center were retrospectively included. The primarily endpoint was 90-day mortality. Univariate and multivariate logistic analyses were performed to identify the risk factors of 90-day mortality.Results: A total of 134 patients were included in our present study. The 90-day mortality rate was 38.06%. Most of the patients (88.81%) reached peak creatine kinase (CK) within 72 hours after admission, and 58 (43.28%) patients received CRRT before the peak CK occurrence (earlier CRRT) and 76 (56.72%) of patients had CRRT after the peak CK occurrence (later CRRT). Multivariate logistic regression analysis showed that CRRT initiation after the peak CK occurrence (OR = 3.74, 95%CI 1.17-11.95, p = 0.026), the elevated serum cTnI (OR = 1.23, 95%CI 1.02-1.49, p = 0.032), and the need of mechanical ventilation support (OR = 7.18, 95%CI 1.67-30.83, p = 0.008) were independent risk factors of 90-day mortality. Similar results were obtained in a subgroup analysis of patients with acute kidney injury (AKI).Conclusions: Earlier CRRT initiation before the peak CK occurrence was associated with lower 90-day patient mortality.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.