Hyponatremia: A Review

被引:58
作者
Buffington, Mary Ansley [1 ]
Abreo, Kenneth [1 ]
机构
[1] LSU Hlth Shreveport Sch Med, Nephrol Sect, Dept Internal Med, Shreveport, LA USA
关键词
hyponatremia; osmotic demyelination syndrome; syndrome of inappropriate antidiuretic hormone; vasopressin receptor antagonist; EXERCISE-ASSOCIATED HYPONATREMIA; CENTRAL PONTINE MYELINOLYSIS; ORAL VASOPRESSIN ANTAGONIST; INTENSIVE-CARE-UNIT; INAPPROPRIATE SECRETION; HYPERTONIC SALINE; SERUM SODIUM; ANTIDIURETIC-HORMONE; PLASMA VASOPRESSIN; HEART-FAILURE;
D O I
10.1177/0885066614566794
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Hyponatremia is the most frequently occurring electrolyte abnormality and can lead to life-threatening complications. This disorder may be present on admission to the intensive care setting or develop during hospitalization as a result of treatment or multiple comorbidities. Patients with acute hyponatremia or symptomatic chronic hyponatremia will likely require treatment in the intensive care unit (ICU). Immediate treatment with hypertonic saline is needed to reduce the risk of permanent neurologic injury. Chronic hyponatremia should be corrected at a rate sufficient to reduce symptoms but not at an excessive rate that would create a risk of osmotic injury. Determination of the etiology of chronic hyponatremia requires analysis of serum osmolality, volume status, and urine osmolality and sodium level. Correct diagnosis points to the appropriate treatment and helps identify risk factors for accelerated correction of the serum sodium level. Management in the ICU facilitates frequent laboratory draws and allows close monitoring of the patient's mentation as well as quantification of urine output. Overly aggressive correction of serum sodium levels can result in neurological injury caused by osmotic demyelination. Therapeutic measures to lower the serum sodium level should be undertaken if the rate increases too rapidly.
引用
收藏
页码:223 / 236
页数:14
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