Fluid restriction does not improve the outcome of acute meningitis

Singhi, Sunit; Singhi, Pratibha; Srinivas, B.; Narakesri, H. P.; Ganguli, N. K.; Sialy, R; Walia, B. N. S.

doi:10.1097/00006454-199506000-00006

Cited by 89 publications

(38 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We identified no systematic reviews or randomised controlled trials evaluating the benefits and harms of urea, demeclocycline, lithium, mannitol, loop diuretics, phenytoin or fluid restriction. We found several case series demonstrating an increase in serum sodium concentration after 2-7 days for urea (202,203,204,205,206), demeclocycline (207), loop diuretics in combination with oral NaCl (123,125,208), phenytoin (209) and fluid restriction (210). We also identified case series of patients experiencing an increase in serum sodium over a longer time period of up to 12 months for urea (211,212,213), up to 3 weeks for demeclocycline (214,215,216,217,218,219), up to 20 weeks for lithium (220), up to 150 days for furosemide with oral NaCl (221) and up to 30 days in phenytoin (220).…”

Section: Rationale † Why This Question?mentioning

confidence: 98%

Clinical practice guideline on diagnosis and treatment of hyponatraemia

Spasovski

Vanholder

Allolio

et al. 2014

European Journal of Endocrinology

608

671

View full text Add to dashboard Cite

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.

show abstract

Section: Rationale † Why This Question?mentioning

confidence: 98%

Clinical practice guideline on diagnosis and treatment of hyponatraemia

Spasovski

Vanholder

Allolio

et al. 2014

European Journal of Endocrinology

608

671

View full text Add to dashboard Cite

show abstract

“…Fluid restriction was effective at increasing PNa in patients with hyponatremia but did not have any advantage in improving outcomes (36). Furthermore, in data obtained in a recent registry of .3000 subjects with hyponatremia, the increase in PNa observed with fluid restriction in the first 24 hours was not significantly different from that observed in untreated patients (37).…”

Section: Limitation Of Water Intakementioning

confidence: 91%

Mild Chronic Hyponatremia in the Ambulatory Setting

Rondon‐Berrios

Berl

2015

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Mild chronic hyponatremia, as defined by a persistent (>72 hours) plasma sodium concentration between 125 and 135 mEq/L without apparent symptoms, is common in ambulatory patients and generally perceived as being inconsequential. The association between increased mortality and hyponatremia in hospitalized patients in various settings and etiologies is widely recognized. This review analyzes the significance of mild chronic hyponatremia in ambulatory subjects and its effects on mortality and morbidity. It addresses whether this disorder should even be treated and if so, which patients are likely to benefit from treatment. The available approaches to correct hyponatremia in such patients in the context of recently published panel-generated recommendations and guidelines are described.

show abstract

“…On the contrary, an acute decrease in circulating sodium (caused by the administration of a 'half normal saline' solution) increases the brain water content [6,7,12]. In conclusion, we advise maintenance plus deficit fluids [4,13] using 'normal saline' in acute meningitis. A prospective study is required to test this hypothesis [12].…”

Section: Discussionmentioning

confidence: 91%

Circulating Sodium in Acute Meningitis

Vigier¹,

Colombo²,

Stoffel³

et al. 2001

Am J Nephrol

View full text Add to dashboard Cite

Background: In acute meningitis hyponatremia is common and traditionally attributed exclusively to inappropriate water retention. However, the exact mechanisms underlying hyponatremia are unknown. Methods: The files of 300 pediatric patients with acute bacterial (n = 190) or aseptic (n = 110) meningitides were retrospectively analyzed. Results: The plasma sodium level ranged from 122 to 148 mmol/l and was low (<133 mmol/l) in 97 patients. Fluid volume contraction was significantly more pronounced in hyponatremia (median 6.0 · 10^–2) than in normonatremia (median 2.0 · 10^–2). The fractional sodium excretion was less than 1.00 · 10^–2 in the 26 hyponatremic children with this measurement. Conclusion: In acute meningitis hyponatremia is not exclusively brought about by inappropriate water retention.

show abstract

Fluid restriction does not improve the outcome of acute meningitis

Cited by 89 publications

References 0 publications

Clinical practice guideline on diagnosis and treatment of hyponatraemia

Clinical practice guideline on diagnosis and treatment of hyponatraemia

Mild Chronic Hyponatremia in the Ambulatory Setting

Circulating Sodium in Acute Meningitis

Contact Info

Product

Resources

About