Fluctuations in Serum Sodium Level Are Associated With an Increased Risk of Death in Surgical ICU Patients*

Sakr, Yasser; Rother, Steffen; Ferreira, Alberto Mendonca Pires; Ewald, Christian; Dünisch, Pedro; Riedemmann, Niels; Reinhart, Konrad

doi:10.1097/ccm.0b013e318265f576

Cited by 105 publications

(109 citation statements)

References 33 publications

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“…However, our observation was similar with the reported 26% prevalence of ICU-acquired hypernatremia in medical-surgical ICUs according to the same definition [19], but lower than that in severe TBI patients (51.5%) [15]. Our findings of 17% hyponatremia on admission was also higher than those on initial measurement to surgical ICU (11.2%) [12] and in teaching hospitals (14.5%) [20]. Another reason for the higher prevalence of dysnatremia was that most of our patients were from outside hospitals or general neurology departments, who were in severe conditions than reported in general ICU.…”

Section: Discussionsupporting

confidence: 78%

“…Even so, our criteria could not account fully for such a high incidence of hypernatremia in NICU. With the same criteria as ours, hypernatremia was seen only in 10% patients in the course of critical illness after major cardiothoracic surgery [17], or 2.5% at admission to the surgical ICU [12]. However, our observation was similar with the reported 26% prevalence of ICU-acquired hypernatremia in medical-surgical ICUs according to the same definition [19], but lower than that in severe TBI patients (51.5%) [15].…”

Section: Discussioncontrasting

confidence: 55%

“…All subjects received standard 0.9% saline according to current guidelines at admission [11,12]. Serum sodium routinely measured by ion-selective electrodes in a Hitachi 7600 clinical analyzer (Hitachi High-Technologies Corporation, Tokyo, Japan) was used for the analysis.…”

Section: Methodsmentioning

confidence: 99%

“…Despite the fact that dysnatremia was independently associated with an increased risk factors for poor prognosis in medical/surgical ICU patients [12,13], insufficient data exist in the literature investigating the association of dysnatremia with the neurocritical illness. Recently it was reported that hypernatremia (serum sodium Na + 150 mEq/l) was seen in 7.9% patients and was more common in patients with mannitol treatment (24.3%) [1].…”

Section: Introductionmentioning

confidence: 99%

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Incidence and Mortality Prognosis of Dysnatremias in Neurologic Critically Ill Patients

2014

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Background: Dysnatremia, which is associated with increased mortality in general intensive care units (ICU), has not been thoroughly studied in neurologic ICU (NICU). Methods: Prevalence of dysnatremia was retrospectively assessed. The multivariable binary logistic regression model was used to determine the influence of dysnatremia on mortality. Results: Of 519 patients, 106 (20.4%) were admitted with hyponatremia and 177 (34.10%) with hypernatremia. Hypernatremia was detected in 69 (13.29%) patients on admission to NICU and in 108 patients (20.81%) during the ICU stay. However, the incidence of dysnatremia did not differ across the neurological categories (p = 0.4690). ICU stay in patients with acquired hypernatremia (22.3 w 25.35 days) was longer than those with admission hypernatremia (13.5 w 12.8 days) or with consistent normonatremia (16.16 w 20.06 days). The other indicators such as Acute Physiology and Chronic Health Evaluation II, Glasgow Coma Scale score, urinary catheterization, and incidence of pneumonia were also associated with the serum sodium concentrations. Hypernatremia both on admission and acquired in NICU could significantly differentiate between survivors and nonsurvivors (p = 0.002 and <0.0001). However, only NICU-acquired hypernatremia was the independent risk factor for mortality with high sensitivity (p = 0.000). Conclusions: Dysnatremia is more common in NICU, whereas only acquired-hypernatremia was independently associated with outcome. i 2014 S. Karger AG, Basel

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Section: Discussionsupporting

confidence: 78%

Section: Discussioncontrasting

confidence: 55%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence and Mortality Prognosis of Dysnatremias in Neurologic Critically Ill Patients

2014

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“…The definitions of mild, moderate and profound hyponatraemia in published research are variable, especially the threshold used to define profound hyponatraemia for which values have ranged from 110 to 125 mmol/l (64,65). Several studies report that when serum sodium concentrations drop below 125 mmol/l, symptoms become more common (61,66,67,68,69,70,71), and the correction to normonatraemia necessitates careful monitoring to avoid overly rapid correction (72).…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

Clinical practice guideline on diagnosis and treatment of hyponatraemia

Spasovski

Vanholder

Allolio

et al. 2014

European Journal of Endocrinology

610

671

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Hyponatraemia, defined as a serum sodium concentration !135 mmol/l, is the most common disorder of body fluid and electrolyte balance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from subtle to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay in patients presenting with a range of conditions. Despite this, the management of patients remains problematic. The prevalence of hyponatraemia in widely different conditions and the fact that hyponatraemia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution-and speciality-based approaches to diagnosis and treatment. To obtain a common and holistic view, the European Society of Intensive Care Medicine (ESICM), the European Society of Endocrinology (ESE) and the European Renal Association -European Dialysis and Transplant Association (ERA-EDTA), represented by European Renal Best Practice (ERBP), have developed the Clinical Practice Guideline on the diagnostic approach and treatment of hyponatraemia as a joint venture of three societies representing specialists with a natural interest in hyponatraemia. In addition to a rigorous approach to methodology and evaluation, we were keen to ensure that the document focused on patient-important outcomes and included utility for clinicians involved in everyday practice.

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Sodium and water homeostasis and derangements

Fielding¹

2014

Equine Fluid Therapy

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Fluctuations in Serum Sodium Level Are Associated With an Increased Risk of Death in Surgical ICU Patients*

Cited by 105 publications

References 33 publications

Incidence and Mortality Prognosis of Dysnatremias in Neurologic Critically Ill Patients

Incidence and Mortality Prognosis of Dysnatremias in Neurologic Critically Ill Patients

Clinical practice guideline on diagnosis and treatment of hyponatraemia

Sodium and water homeostasis and derangements

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