Blood Chemistry Abnormalities in Bacterial Endocarditis of Narcotic Addicts

Ogbuawa, O; Singleton, George T.; Williams, Jeff T.; Henry, W L; Townsend, Jennifer

doi:10.1097/00007611-197812000-00024

Cited by 2 publications

(4 citation statements)

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“…Ogbuawa et al . [ 6 ] noted patients with IVDU and IE to have a clinical picture of SIADH, which we were unable to evaluate due to the retrospective nature of the study. In our patients, we noted hyponatremia to be strongly associated with ADHF.…”

Section: Discussionmentioning

confidence: 94%

“…In the IE population, the etiopathogenesis of hyponatremia is lesser understood. [ 5 6 7 ] Neurohormonal stimulation resulting in release of antidiuretic hormone (ADH) has been implicated in acute infectious and noninfectious processes for mimicking a syndrome of inappropriate ADH secretion (SIADH) like picture. [ 1 2 4 ] Interleukin release in chronic inflammation and infectious disease has been demonstrated to trigger SIADH leading to chronic hyponatremia.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 2 4 ] Interleukin release in chronic inflammation and infectious disease has been demonstrated to trigger SIADH leading to chronic hyponatremia. [ 1 6 ] In an assessment of patients with IVDU, Levine and colleagues[ 7 ] noted hyponatremia in 32% of their 171 patients with the bacterial IE group having a higher incidence compared to the nonbacterial IE patients. Hyponatremic patients had a longer duration of pyrexia (15.8 vs. 5.0 days, P < 0.001), but had no differences in valvular involvement or hospital outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 2 3 4 ] Prior studies have demonstrated hyponatremia to be associated with higher incidence of bacterial IE and mortality in patients with intravenous drug use (IVDU). [ 5 6 7 ] However, the role of hyponatremia has not been systematically evaluated in non-IVDU IE, especially in the Intensive Care Unit (ICU).…”

Section: Introductionmentioning

confidence: 99%

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Association of hyponatremia with in-hospital outcomes in infective endocarditis: A 5-year review from an Indian Intensive Care Unit

Vallabhajosyula

Varma

Vallabhajosyula

et al. 2016

Indian Journal of Critical Care Medicine

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Hyponatremia is commonly noted with cardiovascular disorders, but its role in infective endocarditis (IE) is limited to being a marker of increased morbidity in IE patients with intravenous drug use. This was a 5-year retrospective review from an Indian Intensive Care Unit (ICU). Patients >18 years with IE and available serum sodium levels were included in the study. Pediatric and pregnant patients were excluded from the study. Hyponatremia was defined as admission sodium <135 mmol/L. Detailed data were abstracted from the medical records. Primary outcomes were need for invasive mechanical ventilation, ICU length of stay, and in-hospital mortality. Secondary outcomes included development of acute kidney injury, acute decompensated heart failure (ADHF), acute respiratory distress syndrome, stroke, and severe sepsis in the ICU. Two-tailed P < 0.05 was considered statistically significant. Between January 2010 and December 2014, 96 patients with IE were admitted to the ICU with 85 (88.5%) (median age 46 [34.5–55] years, 51 [60.0%] males) meeting our inclusion criteria. The comorbidities, echocardiographic, and microbiological characteristics were comparable between patients with hyponatremia (56; 65.9%) and eunatremia (29; 34.1%). Median sodium in the hyponatremic cohort was 131 mmol/L (127.25–133) compared to the eunatremic cohort 137 mmol/L (135–139) (P < 0.001). The primary outcomes were not different between the two groups. Hyponatremia was associated more commonly with ADHF (12 [21.4%] vs. 0; P = 0.007) during the ICU stay. Hyponatremia is commonly seen in IE patients and is not associated with worse hospital outcomes. ADHF was seen more commonly in the hyponatremic patients in comparison to those with eunatremia.

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Section: Discussionmentioning

confidence: 94%