Severe Hypernatremia Correction RateMortality in Hospitalized Patients

Alshayeb, Hala M.; Showkat, Arif; Babar, Fatima; Mangold, Therese A.; Wall, Barry M.

doi:10.1097/maj.0b013e31820a3a90

Cited by 94 publications

(77 citation statements)

References 16 publications

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“…While patients with CDI usually have little if any hyperosmolality, patients with osmoreceptor dysfunction can present with severe even life threatening hyperosmolality [61]. ADH secretion due to hypovolemia or decreased BP however, can still be intact [62].…”

Section: Central Diabetes Insipidus (Cdi)mentioning

confidence: 99%

Diabetes Insipidus: A Review

Shapiro¹

2013

J Diabetes Metab

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Section: Central Diabetes Insipidus (Cdi)mentioning

confidence: 99%

Diabetes Insipidus: A Review

Shapiro¹

2013

J Diabetes Metab

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“…Conversely, Alshayeb et al published a clinical investigation highlighting the association of persistent hypernatremia with increased mortality [8]. Fang et al concluded that sodium correction rate of >0.5 mEq/L/h is associated with the development of cerebral edema [9].…”

Section: Discussionmentioning

confidence: 99%

Severe hypernatremia in an adolescent male with anorexia nervosa

Maduemem¹,

Adedokun²

2017

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.comSevere hypernatremia in an adolescent male with anorexia nervosa Kene Ebuka Maduemem, Comfort O. Adedokun ABSTRACT Introduction: Anorexia nervosa is a commonly encountered cause of severe underweight in pediatric settings. It is an eating disorder characterized by the inability to maintain a minimally normal weight, a devastating fear of weight gain, relentless dietary habits that prevent weight gain, and a disturbance in the way in which the body image is perceived. Hypernatremia is an unusual electrolyte imbalance in anorexia nervosa. Case Report: This is a case of a 12-year-old male admitted with progressive weight loss following restrictive food intake for the preceding one year. He presented with severe hypernatremia. Correction of severe hypernatremia was successful after four to five days. This correction was slow but gradually achieved. There was no altered sensorium throughout admission which remains the worst nightmare of any managing team. Feeding protocol as per Junior MARSIPAN guidelines was adhered to. He made an excellent recovery and was discharged after 24 days of admission with a weight gain of 6.1 kg. Conclusion: Anorexia nervosa is commonly encountered in pediatric settings and can cause potentially life-threatening physical and psychological complications. Hypernatremia is an uncommon metabolic abnormality; slow correction averts untoward side effects.

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“…Other studies have shown similar results: a retrospective review of 131 patients with severe hypernatraemia found that, although the rate of sodium reduction was as recommended (<0.5 mmol/l/h) in 90% of patients, hypernatraemia was corrected in only 27% of patients after 72 h of treatment. 11 Explanations for the current results might be that the rate of fl uid infusion was not calculated or that sodium levels were not rechecked often enough. Improving the management of patients with hypernatraemia will require education of frontline junior staff, and an accessible and straightforward protocol, which ideally incorporates the water defi cit formula in a simple calculation.…”

Section: Discussionmentioning

confidence: 99%

The management of patients presenting with hypernatraemia: is aggressive management appropriate?

Maggs

2014

Clinical Medicine

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Hypernatraemia is a common fi nding among patients presenting to hospital. The aim of this observational study was to discover what types of patients presented with hypernatraemia and whether they were appropriately managed. The management of hypernatraemia was audited against common standards of care. Hypernatraemia at presentation carries a poor prognosis and in this study management of hypernatraemia was found to be done poorly, possibly because for many patients aggressive management was deemed inappropriate. The majority of patients who present with hypernatraemia are older, dependent and/or suffer from cognitive impairment. Many of these patients do not have a reversible cause for their hypernatraemia. These patients need to be recognised, ideally in the community, so that inappropriate admission can be avoided, but also on presentation to hospital so that appropriate care, which may be end-of-life care, can be provided.

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Severe Hypernatremia Correction RateMortality in Hospitalized Patients

Cited by 94 publications

References 16 publications

Diabetes Insipidus: A Review

Diabetes Insipidus: A Review

Severe hypernatremia in an adolescent male with anorexia nervosa

The management of patients presenting with hypernatraemia: is aggressive management appropriate?

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