Determinants of hyponatremia following a traumatic brain injury

Léveillé, Etienne; Aljassar, Meshal; Beland, Benjamin; Saeedi, Rothaina; Marcoux, Judith

doi:10.1007/s10072-022-05894-3

Cited by 3 publications

(4 citation statements)

References 32 publications

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“…There is still debate in human medicine regarding the underlying pathophysiology of hyponatremia associated with TBI. 7 Furthermore, the exact incidence or even the existence of CSWS associated with intracranial disease is still under debate. 24 Reports of CSWS associated with subarachnoid hemorrhages and infectious agents appear more common.…”

Section: Discussionmentioning

confidence: 99%

“…In future veterinary patients suffering hyponatremia after brain injuries, it is recommended to consider taking these additional steps to assist in making a more definitive diagnosis of CSWS. There is still debate in human medicine regarding the underlying pathophysiology of hyponatremia associated with TBI 7 . Furthermore, the exact incidence or even the existence of CSWS associated with intracranial disease is still under debate 24 .…”

Section: Discussionmentioning

confidence: 99%

“…6 The incidence of hyponatremia in people with TBI has been reported to be 15%-50%, depending on the population included. 7 The incidence of this has not been documented in veterinary medicine. Given that controlling hyponatremia prevents the worsening of secondary brain injury, monitoring and intervention may be important to limit further neuronal death.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the presence or development of hyponatremia has been associated with increased mortality in both human and veterinary patients alike 6 . The incidence of hyponatremia in people with TBI has been reported to be 15%–50%, depending on the population included 7 . The incidence of this has not been documented in veterinary medicine.…”

Section: Introductionmentioning

confidence: 99%

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Suspected cerebral salt wasting syndrome secondary to traumatic brain injury in a dog

Chromiak,

Finstad,

Cooper

2024

J Vet Emergen Crit Care

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ObjectiveTo describe a dog with suspected cerebral salt wasting syndrome (CSWS) secondary to traumatic brain injury (TBI).Case SummaryA 2‐month‐old intact male Chihuahua‐American Pitbull Terrier mix weighing 1.94 kg presented to a veterinary teaching emergency room after suffering bite wound‐penetrating trauma to the head. Treatment was initiated with hyperosmotic agents, fluid resuscitation, and analgesia. The dog's neurologic dysfunction warranted hospitalization and continuous monitoring. Within 24 hours, the dog developed hyponatremia (133 mmol/L compared to 143 mmol/L on presentation [reference interval 142–149 mmol/L]). As the dog had concurrent tachycardia, increase in urine sodium concentration, polyuria, and weight loss, a diagnosis of cerebral salt wasting was suspected. A 2% hypertonic saline constant rate infusion was administered for volume replacement, and the patient showed improvement in clinical signs and blood sodium concentration. The dog was discharged on Day 5. Recheck examination showed significant neurologic improvement with sodium just below the low end of the reference range (141 mmol/L [reference interval 142–149 mmol/L]).New or Unique Information ProvidedThis is the first description of suspected CSWS in veterinary medicine. Hyponatremia is a common finding in critically ill neurologic people, including those with TBI, and is typically associated with either syndrome of inappropriate antidiuretic hormone or CSWS. As treatment recommendations for syndrome of inappropriate antidiuretic hormone and CSWS are diametrically opposed, identifying the presence of hyponatremia and distinguishing between these 2 clinical entities is critical for improving patient care for those with TBI. This case highlights the characteristics and clinical progression regarding the diagnosis and management of suspected CSWS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Suspected cerebral salt wasting syndrome secondary to traumatic brain injury in a dog

Chromiak,

Finstad,

Cooper

2024

J Vet Emergen Crit Care

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Initial dysnatremia and clinical outcomes in pediatric traumatic brain injury: a multicenter observational study

Mai,

Lee,

Caporal

et al. 2024

Acta Neurochir

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Hyponatremia Related to Neurocritical Care: Focus on Diagnosis and Therapy: A Systematic Review

Mezzini

Marasco

Bertuccio

et al. 2023

RRCT

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Introduction: Hyponatremia is the most frequently occurring electrolyte disorder in neurocritical care and traumatic brain injury, aneurysmal subarachnoid hemorrhage (SAH), neurosurgery, and ischemic stroke are the clinical conditions more often associated with this condition. SIADH and CSWS are the main causes of hyponatremia in neurologically ill patients. Since hyponatremia is a negative prognostic factor for neurocritical patients, early diagnosis and consequent targeted therapy are of fundamental importance. The present review was carried out to provide a brief recap on the main causes and management of hyponatremia in the neurocritical patient. Materials and methods: A methodical search of the medical literature using the online database MEDLINE was carried out and studies comprising case reports, prospective and retrospective observational studies, or randomized controlled clinical trials in which there is a diagnosis of hyponatremia in neurocritical patients were included. Results: 18 articles were analyzed, consisting of 8 case reports, 4 case series, 3 prospective trials, 1 retrospective study, and 1 multicenter trial. A total of 1371 patients from 18 studies were included. Patients’ average age was 29.28 ± 20.9, respectively. TBI was the main cause of hyponatremia in the literature reviewed; 12 studies were about the relationship between TBI and hyponatremia, 2 studies about stroke, 2 studies about SAH and 1 about hyponatremia post-neurosurgical procedure. Discussion: Discussion Hyponatremia is the most common electrolyte disorder in hospitalized patients and the main scenarios of hyponatremic neurocritical patients are subarachnoid hemorrhage, ischemic stroke, traumatic brain injury and iatrogenic hyponatremia due to neurosurgical cases. Conclusion: Hyponatremia is a frequent finding in neurocritical care and is also a recognized negative prognostic factor leading to increased mortality and ICU length hospitalization. Its diagnosis and therapy are essential for correct neurocritical management. The most common cause of serum sodium abnormality is SIADH, and an early diagnosis for target treatment is paramount to prevent delayed symptoms and complications.

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Determinants of hyponatremia following a traumatic brain injury

Cited by 3 publications

References 32 publications

Suspected cerebral salt wasting syndrome secondary to traumatic brain injury in a dog

Suspected cerebral salt wasting syndrome secondary to traumatic brain injury in a dog

Initial dysnatremia and clinical outcomes in pediatric traumatic brain injury: a multicenter observational study

Hyponatremia Related to Neurocritical Care: Focus on Diagnosis and Therapy: A Systematic Review

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