Hyponatraemia as a risk factor for hospital mortality

Asadollahi, Khairollah; Beeching, Nicholas J.; Gill, Geoff

doi:10.1093/qjmed/hcl120

Cited by 84 publications

(98 citation statements)

References 20 publications

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“…Hyponatraemia is a recognised risk factor for mortality in the general population and patients admitted to hospital [1]. Traditionally this risk has been ascribed to underlying co-morbidity, such as congestive cardiac failure, cirrhosis and tumour induced inappropriate ADH syndrome.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Serum Sodium on Survival in Patients Treated by Peritoneal Dialysis in the United Kingdom

2017

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Section: Discussionmentioning

confidence: 99%

The Effect of Serum Sodium on Survival in Patients Treated by Peritoneal Dialysis in the United Kingdom

2017

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“…Dano cerebral e morte têm sido descritos como associados à hiponatremia adquirida em hospital, tanto em crianças como em adultos [2][3][4] . O principal fator que contribui para o desenvolvimento desse distúrbio em pacientes hospitalizados parece ser o uso rotineiro de fluidos hipotônicos nos que apresentam a excreção de água livre prejudicada, como aqueles com excesso de arginina vasopressina (AVP) [5][6][7] .…”

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Isotonic saline solution as maintenance intravenous fluid therapy to prevent acquired hyponatremia in hospitalized children

Alves¹,

Troster²,

Oliveira³

2011

J Pediatr (Rio J)

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Objectives: This review aims to evaluate if the use of hypotonic saline solutions as maintenance intravenous fluid therapy in hospitalized children increases the risk of hyponatremia, if the administration of isotonic fluids is able to protect against acquired hyponatremia and if the isotonic solutions increase the risks of deleterious effects such as hypernatremia or fluid overload. Sources:We researched the relevant literature on the PubMed (Jan 01 1969 to Jul 13 2011), EMBASE (1989to 2011) and Cochrane Library (1989to 2011 databases. Furthermore, references of selected studies were included. Summary of the findings:Hospitalized children are potentially at risk of developing hyponatremia and the use of hypotonic saline solutions is the main risk factor for this disease. Isotonic saline solutions have shown a protective effect against hyponatremia, and, so far, there have been no significant deleterious effects such as fluid overload, hypernatremia or phlebitis. Conclusions:The evidence found indicates that the traditional recommendation of Holliday and Segar to use maintenance fluid therapy for sick and hospitalized children deserves to be reconsidered due to the adverse effects found to arise from it, apart from the better results obtained by using isotonic solutions.J Pediatr (Rio J). 2011;87(6):478-86: Isotonic solutions, hypotonic solutions, fluid therapy, hyponatremia, child, hospitalization. ResumoObjetivos: Avaliar se o uso de soluções salinas hipotônicas como fluidoterapia de manutenção em crianças hospitalizadas aumenta o risco de hiponatremia, se a administração de fluidos isotônicos é capaz de proteger contra a hiponatremia adquirida e se as soluções isotôni-cas aumentam os riscos de efeitos deletérios como hipernatremia ou sobrecarga hídrica. Síntese dos dados:Crianças hospitalizadas têm riscos potenciais para hiponatremia, e o uso de soluções salinas hipotônicas é o principal fator de risco para esse agravo. As soluções salinas isotônicas têm mostrado efeito protetor para hiponatremia e, até o momento, sem efeitos deletérios significativos, como sobrecarga hídrica, hipernatremia ou flebites. Conclusões:As evidências indicam que a tradicional recomendação de Holliday & Segar quanto à fluidoterapia de manutenção para crianças doentes e hospitalizadas merece ser reconsiderada em virtude das evidên-cias sobre os efeitos adversos dela advindos, assim como dos melhores resultados obtidos com o emprego das soluções isotônicas. J Pediatr (Rio J) IntroduçãoA hiponatremia é definida como a concentração do sódio sérico inferior a 136 mmol/L. Quando sintomático, esse distúrbio pode manifestar-se por disfunção do sistema nervoso central (SNC), caracterizado por: cefaleia, náuseas, vômitos, letargia, desorientação, depressão de reflexos tendinosos, convulsões, disfunção neurológica permanente, morte por

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“…The treatment plan for the severe hyponatraemic or symptomatic cases was an intravenous infusion of hypertonic (3%) saline (100 ml) over 4 hours, with monitoring of the serum Sodium twice daily. The rate of correction of serum sodium was slow and it was limited to 2 meq/l per hour or a maximum of 20 meq/l per day, until a serum sodium level of 135 meq/l was achieved [13,14]. The serum osmolarity was calculated on the basis of the fasting blood sugar, the serum blood urea nitrogen (BUN) and the initial serum sodium value.…”

Section: Methodsmentioning

confidence: 99%

The Incidence of Hyponatraemia and Its Effect on the ECOG Performance Status among Lung Cancer Patients

Sengupta

Banerjee²,

Biswas³

et al. 2013

JCDR

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Context: Hyponatraemia is one of the common electrolytic disorders which are associated with lung cancer. Hyponatraemia may influence the ECOG performance status at presentation. Also, to the best of our knowledge, we found only limited Indian studies where the ECOG score was correlated with the serum sodium status in lung cancer patients on presentation. Aim:To assess the incidence of hyponatraemia among the patients of carcinoma of the lung before putting them into the specific treatment category for cancer and to check the effects on their ECOG performance status. Settings and Design:A cross-sectional, observational study was conducted on 116 consecutive patients of lung cancer during the period from November 2011 to October 2012. Material and Methods:The patients with a histologically proven diagnosis of lung cancer were grouped initially according to their ECOG performance statuses. The serum sodium value of each patient was measured and the hyponatraemic patients were given treatment according to the protocol. The correlation of the ECOG performance status with the serum sodium of the lung cancer patients was measured. To check for any laboratory error in serum sodium, we selected (n = 58) age, sex and socioeconomic matched control patients.Results: At presentation 44.8% of the lung cancer patients showed hyponatraemia [52/116]. The ECOG score was significantly poor in the advanced clinical stages (ECOG ≤2 Vs ECOG ≥ 3 in NSCLC cases, c 2 =11.25, P=.0008). The ECOG performance status score at admission showed a negative correlation with the serum sodium status which was measured on admission among all the patients (Pearson correlation coefficient = -0.186). The clinical stage of the lung cancer also showed a positive correlation with the ECOG score at admission in our study (Pearson correlation coefficient = 0.295).

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Hyponatraemia as a risk factor for hospital mortality

Cited by 84 publications

References 20 publications

The Effect of Serum Sodium on Survival in Patients Treated by Peritoneal Dialysis in the United Kingdom

The Effect of Serum Sodium on Survival in Patients Treated by Peritoneal Dialysis in the United Kingdom

Isotonic saline solution as maintenance intravenous fluid therapy to prevent acquired hyponatremia in hospitalized children

The Incidence of Hyponatraemia and Its Effect on the ECOG Performance Status among Lung Cancer Patients

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