Protocol of Diagnostic and Treatment of Hyponatremia and Hypernatremia in Neurocritical Care

Dysnatremias are common and serious complications in neurocritical care. They pose a risk mainly due to their effect on osmolality of extracellular fluids that influences the amount of water in intracellular fluids. Hyponatremia is associated with a risk of brain edema, while hypernatremia can cause brain dehydration. Hyponatremia occurs more frequently but hypernatremia is associated with poorer prognosis, serum sodium above 160 mmol/l is an independent risk factor for higher mortality. Risk factors for dysnatremias include: 1. brain damage, 2. therapeutic processes during neurocritical care, 3. iatrogenic conditions. One of the aims of neurocritical care is to prevent iatrogenic hypo/hypernatremias.