Polyuria in relation to dysnatraemias in neurocritical care

Špatenková, Věra; Bradáč, Ondřej; Lacy, Patricia de; Skrabalek, Pavel

doi:10.3109/02688697.2015.1054347

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…Hyponatremia before surgery and on POD 1–2 were extracted as binary variables. We also collected polyuria on POD 1–2 as a binary variable, defined as urine output exceeding 4000 ml/day [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

Predictors and dynamic online nomogram for postoperative delayed hyponatremia after endoscopic transsphenoidal surgery for pituitary adenomas: a single-center, retrospective, observational cohort study with external validation

et al. 2023

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Background Postoperative delayed hyponatremia (PDH) is a major cause of readmission after endoscopic transsphenoidal surgery (eTSS) for pituitary adenomas (PAs). However, the risk factors associated with PDH have not been well established, and the development of a dynamic online nomogram for predicting PDH is yet to be realized. We aimed to investigate the predictive factors for PDH and construct a dynamic online nomogram to aid in its prediction. Methods We analyzed the data of 226 consecutive patients who underwent eTSS for PAs at the Department of Neurosurgery in Jinling Hospital between January 2018 and October 2020. An additional 97 external patients were included for external validation. PDH was defined as a serum sodium level below 137 mmol/L, occurring on the third postoperative day (POD) or later. Results Hyponatremia on POD 1–2 (OR = 2.64, P = 0.033), prothrombin time (PT) (OR = 1.78, P = 0.008), and percentage of monocytes (OR = 1.22, P = 0.047) were identified as predictive factors for PDH via multivariable logistic regression analysis. Based on these predictors, a nomogram was constructed with great discrimination in internal validation (adjusted AUC: 0.613–0.688) and external validation (AUC: 0.594–0.617). Furthermore, the nomogram demonstrated good performance in calibration plot, Brier Score, and decision curve analysis. Subgroup analysis revealed robust predictive performance in patients with various clinical subtypes and mild to moderate PDH. Conclusions Preoperative PT and the percentage of monocytes were, for the first time, identified as predictive factors for PDH. The dynamic nomogram proved to be a valuable tool for predicting PDH after eTSS for PAs and demonstrated good generalizability. Patients could benefit from early identification of PDH and optimized treatment decisions.

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Section: Methodsmentioning

confidence: 99%

Predictors and dynamic online nomogram for postoperative delayed hyponatremia after endoscopic transsphenoidal surgery for pituitary adenomas: a single-center, retrospective, observational cohort study with external validation

et al. 2023

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“…Cerebral salt wasting syndrome and SIADH have different pathogenesis. However, it is not always easy to distinguish in the clinic, and they can be observed in the same patient [96][97][98][99][100].…”

Section: Complications and Current Treatment Approachesmentioning

confidence: 99%

Intensive Care Management in Cerebral Aneurysm and Arteriovenous Malformations

Ozkan¹

2020

Vascular Malformations of the Central Nervous System

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Aneurysmal subarachnoid hemorrhage is an important group of intracranial hemorrhage with a high risk of disability and mortality. The initial amount of bleeding, rebleeding, and delayed cerebral ischemia are considered as the most important factors in determining the prognosis of aneurysm-induced bleeding. In arteriovenous malformations, its location and deep venous drainage play a role in the prognosis. Cardiac complications, neurogenic pulmonary edema, hypertension, hyperglycemia, infections, and prolonged mechanical ventilation in aneurysmal subarachnoid hemorrhage lead to morbidity and mortality. Aneurysm bleeding control, appropriate fluid replacement to ensure euvolemia, when necessary external ventricular drainage and/or decompressive craniectomy, mannitol or hypertonic saline application, and infection control are the main principles of treatment.

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