12 results on '"Hoorn, Ewout J'
Search Results
2. Overcorrection and undercorrection with fixed dosing of bolus hypertonic saline for symptomatic hyponatremia
- Author
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Anissa Pelouto, Julie C Refardt, Mirjam Christ-Crain, Adrienne A M Zandbergen, Ewout J Hoorn, and Internal Medicine
- Subjects
Endocrinology ,SDG 3 - Good Health and Well-being ,Endocrinology, Diabetes and Metabolism ,General Medicine - Abstract
ObjectiveCurrent guidelines recommend treating symptomatic hyponatremia with rapid bolus-wise infusion of fixed volumes of hypertonic saline regardless of body weight. We hypothesize that this approach is associated with overcorrection and undercorrection in patients with low and high body weight.DesignSingle-center, retrospective cohort study.MethodsData were collected on patients treated with ≥1 bolus 100 or 150 mL 3% NaCl for symptomatic hyponatremia between 2017 and 2021. Outcomes were overcorrection (plasma sodium rise > 10 mmol/L/24 h, > 18 mmol/L/48 h, or relowering therapy) and undercorrection (plasma sodium rise < 5 mmol/L/24 h). Low body weight and high body weight were defined according to the lowest (≤60 kg) and highest (≥80 kg) quartiles.ResultsHypertonic saline was administered to 180 patients and caused plasma sodium to rise from 120 mmol/L to 126.4 mmol/L (24 h) and 130.4 mmol/L (48 h). Overcorrection occurred in 32 patients (18%) and was independently associated with lower body weight, weight ≤ 60 kg, lower baseline plasma sodium, volume depletion, hypokalemia, and less boluses. In patients without rapidly reversible causes of hyponatremia, overcorrection still occurred more often in patients ≤ 60 kg. Undercorrection occurred in 52 patients (29%) and was not associated with body weight or weight ≥ 80 kg but was associated with weight ≥ 100 kg and lean body weight in patients with obesity.ConclusionOur real-world data suggest that fixed dosing of bolus hypertonic saline may expose patients with low and high body weight to more overcorrection and undercorrection, respectively. Prospective studies are needed to develop and validate individualized dosing models.
- Published
- 2023
3. Overcorrection and undercorrection with fixed dosing of bolus hypertonic saline for symptomatic hyponatremia
- Author
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Pelouto, Anissa, primary, Refardt, Julie C, additional, Christ-Crain, Mirjam, additional, Zandbergen, Adrienne A M, additional, and Hoorn, Ewout J, additional
- Published
- 2023
- Full Text
- View/download PDF
4. ENDOCRINOLOGY IN THE TIME OF COVID-19-2021 UPDATES: The management of diabetes insipidus and hyponatraemia
- Author
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Mirjam Christ-Crain, John A.H. Wass, Mark Sherlock, Christopher J. Thompson, and Ewout J. Hoorn
- Subjects
medicine.medical_specialty ,Consensus ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,History, 21st Century ,Severity of Illness Index ,Distance Counseling ,Thirst ,Endocrinology ,Internal medicine ,Severity of illness ,medicine ,Ambulatory Care ,Humans ,Practice Patterns, Physicians' ,Desmopressin ,Expert Testimony ,Pandemics ,business.industry ,SARS-CoV-2 ,Acute kidney injury ,COVID-19 ,General Medicine ,medicine.disease ,Clinical Practice Guidance ,Telemedicine ,Hospitalization ,Diabetes insipidus ,medicine.symptom ,business ,Hyponatremia ,Complication ,Fluid replacement ,Diabetes Insipidus ,medicine.drug - Abstract
COVID-19 has changed the nature of medical consultations, emphasizing virtual patient counselling, with relevance for patients with diabetes insipidus (DI) or hyponatraemia. The main complication of desmopressin treatment in DI is dilutional hyponatraemia. Since plasma sodium monitoring is not always possible in times of COVID-19, we recommend to delay the desmopressin dose once a week until aquaresis occurs allowing excess retained water to be excreted. Patients should measure their body weight daily. Patients with DI admitted to the hospital with COVID-19 have a high risk for mortality due to volume depletion. Specialists must supervise fluid replacement and dosing of desmopressin. Patients after pituitary surgery should drink to thirst and measure their body weight daily to early recognize the development of postoperative SIAD. They should know hyponatraemia symptoms. Hyponatraemia in COVID-19 is common with a prevalence of 20–30% and is mostly due to SIAD or hypovolaemia. It mirrors disease severity and is an early predictor of mortality. Hypernatraemia may also develop in COVID-19 patients, with a prevalence of 3–5%, especially in ICU, and derives from different multifactorial reasons, for example, due to insensible water losses from pyrexia, increased respiration rate and use of diuretics. Hypernatraemic dehydration may contribute to the high risk of acute kidney injury in COVID-19. IV fluid replacement should be administered with caution in severe cases of COVID-19 because of the risk of pulmonary oedema.
- Published
- 2021
5. ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of diabetes insipidus and hyponatraemia
- Author
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Mirjam Christ-Crain, Mark Sherlock, John A.H. Wass, Ewout J. Hoorn, Christopher J. Thompson, and Internal Medicine
- Subjects
medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Pneumonia, Viral ,030209 endocrinology & metabolism ,Neurosurgical Procedures ,Thirst ,Inappropriate ADH Syndrome ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Endocrinology ,SDG 3 - Good Health and Well-being ,Internal medicine ,Humans ,Medicine ,Deamino Arginine Vasopressin ,Desmopressin ,Pandemics ,Hypernatremia ,Dehydration ,business.industry ,Antidiuretic Agents ,Acute kidney injury ,COVID-19 ,Disease Management ,Shock ,General Medicine ,medicine.disease ,Clinical Practice Guidance ,Diabetes Insipidus, Neurogenic ,Hypotonic Solutions ,Brain Injuries ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Diabetes insipidus ,Fluid Therapy ,Saline Solution ,medicine.symptom ,Coronavirus Infections ,business ,Hyponatremia ,Complication ,Fluid replacement ,Diabetes Insipidus ,medicine.drug - Abstract
COVID-19 has changed the nature of medical consultations, emphasizing virtual patient counseling, with relevance for patients with diabetes insipidus (DI) or hyponatraemia. The main complication of desmopressin treatment in DI is dilutional hyponatraemia. Since plasma sodium monitoring is not always possible in times of COVID-19, we recommend to delay the desmopressin dose once a week until aquaresis occurs allowing excess retained water to be excreted. Patients should measure their body weight daily. Patients with DI admitted to the hospital with COVID-19 have a high risk for mortality due to volume depletion. Specialists must supervise fluid replacement and dosing of desmopressin. Patients after pituitary surgery should drink to thirst and measure their body weight daily to early recognize the development of the postoperative syndrome of inappropriate antidiuresis (SIAD). They should know hyponatraemia symptoms. The prevalence of hyponatraemia in patients with pneumonia due to COVID-19 is not yet known, but seems to be low. In contrast, hypernatraemia may develop in COVID-19 patients in ICU, from different multifactorial reasons, for example, due to insensible water losses from pyrexia, increased respiration rate and use of diuretics. Hypernatraemic dehydration may contribute to the high risk of acute kidney injury in COVID-19. IV fluid replacement should be administered with caution in severe cases of COVID-19 because of the risk of pulmonary oedema.
- Published
- 2020
6. ENDOCRINOLOGY IN THE TIME OF COVID-19-2021 UPDATES: The management of diabetes insipidus and hyponatraemia
- Author
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Christ-Crain, Mirjam, primary, Hoorn, Ewout J, additional, Sherlock, Mark, additional, Thompson, Chris J, additional, and Wass, John, additional
- Published
- 2021
- Full Text
- View/download PDF
7. ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of diabetes insipidus and hyponatraemia
- Author
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Christ-Crain, Mirjam, primary, Hoorn, Ewout J, additional, Sherlock, Mark, additional, Thompson, Chris J, additional, and Wass, John A H, additional
- Published
- 2020
- Full Text
- View/download PDF
8. The management of diabetes insipidus and hyponatraemia.
- Author
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Christ-Crain, Mirjam, Hoorn, Ewout J., Sherlock, Mark, Thompson, Chris J., and Wass, John
- Subjects
- *
DIABETES insipidus , *COVID-19 pandemic , *ACUTE kidney failure , *COVID-19 , *SYMPTOMS , *PULMONARY edema - Abstract
COVID-19 has changed the nature of medical consultations, emphasizing virtual patient counselling, with relevance for patients with diabetes insipidus (DI) or hyponatraemia. The main complication of desmopressin treatment in DI is dilutional hyponatraemia. Since plasma sodium monitoring is not always possible in times of COVID-19, we recommend to delay the desmopressin dose once a week until aquaresis occurs allowing excess retained water to be excreted. Patients should measure their body weight daily. Patients with DI admitted to the hospital with COVID-19 have a high risk for mortality due to volume depletion. Specialists must supervise fluid replacement and dosing of desmopressin. Patients after pituitary surgery should drink to thirst and measure their body weight daily to early recognize the development of postoperative SIAD. They should know hyponatraemia symptoms. Hyponatraemia in COVID-19 is common with a prevalence of 20-30% and is mostly due to SIAD or hypovolaemia. It mirrors disease severity and is an early predictor of mortality. Hypernatraemia may also develop in COVID-19 patients, with a prevalence of 3-5%, especially in ICU, and derives from different multifactorial reasons, for example, due to insensible water losses from pyrexia, increased respiration rate and use of diuretics. Hypernatraemic dehydration may contribute to the high risk of acute kidney injury in COVID -19. IV fluid replacement should be administered with caution in severe cases of COVID-19 because of the risk of pulmonary oedema. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
9. Clinical practice guideline on diagnosis and treatment of hyponatraemia
- Author
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Goce, Spasovski, Raymond, Vanholder, Bruno, Allolio, Djillali, Annane, Steve, Ball, Daniel, Bichet, Guy, Decaux, Wiebke, Fenske, Ewout J, Hoorn, Ewout, Hoorn, Carole, Ichai, Michael, Joannidis, Alain, Soupart, Robert, Zietse, Maria, Haller, Sabine, van der Veer, Wim, Van Biesen, Evi, Nagler, Internal Medicine, APH - Amsterdam Public Health, Other Research, and Medical Informatics
- Subjects
medicine.medical_specialty ,moderate ,Moderate ,Endocrinology, Diabetes and Metabolism ,MEDLINE ,Placebo-controlled study ,Alternative medicine ,Mild ,Sodium Chloride ,Critical Care and Intensive Care Medicine ,Severity of Illness Index ,Endocrinology ,Anesthesiology ,Internal medicine ,Severity of illness ,Epidemiology ,medicine ,mild ,Humans ,Intensive care medicine ,Transplantation ,Severe ,Néphrologie - urologie ,business.industry ,severe ,Osmolar Concentration ,Sodium ,nutritional and metabolic diseases ,acute ,Evidence-based medicine ,General Medicine ,Guideline ,medicine.disease ,Transplantation d'organes ,RC31-1245 ,chronic ,Clinical Practice ,Nephrology ,Hyponatremia ,business - Abstract
Hyponatraemia, defined as a serum sodium concentration, SCOPUS: ar.j, info:eu-repo/semantics/published
- Published
- 2014
10. Management of diabetes insipidus and hyponatraemia.
- Author
-
Christ-Crain, Mirjam, Hoorn, Ewout J., Sherlock, Mark, Thompson, Chris J., and Wass, John A. H.
- Abstract
COVID-19 has changed the nature of medical consultations, emphasizing virtual patient counseling, with relevance for patients with diabetes insipidus (DI) or hyponatraemia. The main complication of desmopressin treatment in DI is dilutional hyponatraemia. Since plasma sodium monitoring is not always possible in times of COVID-19, we recommend to delay the desmopressin dose once a week until aquaresis occurs allowing excess retained water to be excreted. Patients should measure their body weight daily. Patients with DI admitted to the hospital with COVID-19 have a high risk for mortality due to volume depletion. Specialists must supervise fluid replacement and dosing of desmopressin. Patients after pituitary surgery should drink to thirst and measure their body weight daily to early recognize the development of the postoperative syndrome of inappropriate antidiuresis (SIAD). They should know hyponatraemia symptoms. The prevalence of hyponatraemia in patients with pneumonia due to COVID-19 is not yet known, but seems to be low. In contrast, hypernatraemia may develop in COVID-19 patients in ICU, from different multifactorial reasons, for example, due to insensible water losses from pyrexia, increased respiration rate and use of diuretics. Hypernatraemic dehydration may contribute to the high risk of acute kidney injury in COVID-19. IV fluid replacement should be administered with caution in severe cases of COVID-19 because of the risk of pulmonary oedema. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
11. The association of thyroid function and the risk of kidney function decline: a population-based cohort study
- Author
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Chaker, Layal, primary, Sedaghat, Sanaz, additional, Hoorn, Ewout J, additional, Elzen, Wendy P J Den, additional, Gussekloo, Jacobijn, additional, Hofman, Albert, additional, Ikram, M Arfan, additional, Franco, Oscar H, additional, Dehghan, Abbas, additional, and Peeters, Robin P, additional
- Published
- 2016
- Full Text
- View/download PDF
12. Clinical practice guideline on diagnosis and treatment of hyponatraemia
- Author
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Spasovski, Goce, primary, Vanholder, Raymond, additional, Allolio, Bruno, additional, Annane, Djillali, additional, Ball, Steve, additional, Bichet, Daniel, additional, Decaux, Guy, additional, Fenske, Wiebke, additional, Hoorn, Ewout J, additional, Ichai, Carole, additional, Joannidis, Michael, additional, Soupart, Alain, additional, Zietse, Robert, additional, Haller, Maria, additional, van der Veer, Sabine, additional, Van Biesen, Wim, additional, and Nagler, Evi, additional
- Published
- 2014
- Full Text
- View/download PDF
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