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Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Sodium disorders, the most common electrolyte disorders in hospitalized patients, are common in hospitalized patients with pneumonia. Numerous studies have shown that sodium abnormalities are independent risk factors for mortality, medical intensive care unit (ICU) admission, and prolonged hospital stay. The aim of the study was to investigate the prevalence of dysnatremia and the effect of dysnatremia on prognosis and mortality in critically ill COVID-19 patients. Methods: This retrospective study was performed between June 1, 2021, and July 30, 2021, in COVID-19 ICUs. 149 critically ill, laboratory-confirmed COVID-19 patients admitted to the ICU were included in the study. The collected data included demographic data, comorbidities, severity of illness, and laboratory tests (serum C-reactive protein, lymphocyte, ferritin, sodium, chloride, and potassium levels). The prognosis was evaluated in terms of mortality, need for mechanical ventilation, and length of ICU stay. Results: At ICU admission, hyponatremia was present in 33 (22.1%) patients, whereas hypernatremia was detected in 14 (9.5%) patients. 102 (68.4%) patients had normal sodium levels. The mortality rate for normonatremic, hyponatremic, and hypernatremic patients was 50.0%, 57.7%, and 78.6%, respectively. These results indicated a statistically significantly higher mortality rate in patients with baseline hypernatremia (p=0.05). Conclusion: Among critically ill COVID-19 patients in the ICU, dysnatremia was common at admission and hyponatremia was more common than hypernatremia. Hypernatremia was related to mortality. Admission sodium levels can be a predictor of mortality in COVID-19 patients who are critically ill. [ABSTRACT FROM AUTHOR]

Background: sodium disorders are the most common and least understood in patients with acute brain injury due to the major role played by the central nervous system in regulating sodium and water homeostasis, which can lead to serious complications and adverse outcomes, including death.Objective: to determine the hypernatremia contribution to mortality in patients with neurological conditions in critical state. Methods: longitudinal analytical observational study on 55 patients who were admitted to the acute care units at the Arnaldo Milián Castro University Hospital, between October 2020 and May 2022, regardless of the plasma sodium value upon admission to the service, as well as during their stay in the critical care units. Univariate and bivariate statistical methods were used in data analysis. Results: the average age was 60 ± 16 years. The most relevant diagnoses were intraparenchymal hemorrhage (56.37%), head trauma, and ischemic stroke (both 30%). Plasma sodium concentrations showed significant differences (pX2= 0.000), with the highest average at 24 hours of admission (174.2 ± 133.6) and the lowest at the 5th day (102.9 ± 72.9). There was a significant correlation between plasma sodium concentrations at admission, 24h and 72h with the state at discharge. In the individual bivariate analysis by period, there was only a significant relationship after 24 hours. In this period, hypernatremia contributed 1.78 times more to mortality than in those who did not have elevated sodium (OR=1.78 with CI: 1,39-3,4).Conclusions: hypernatremia in critically ill patients with neurological conditions is associated with increased mortality.

Introduction: hyperchloremia and hypernatremia are common complications in critically ill children and have been associated with the development of acute kidney injury (AKI) and mortality. Objective: to estimate the incidence of hyperchloremia and hypernatremia during the first 72 hours of admission to a pediatric intensive care unit (PICU), and to evaluate their association with AKI and mortality. Material and methods: prospective cohort study, conducted over a period of 15 months. Patients with disorders in plasma levels of chloride (Cl-) or sodium (Na+), as well as with AKI at the time of admission, were excluded. Values > 110 mEq/L Cl- and > 145 mEq/L Na+ were considered as hyperchloremia and hypernatremia, respectively. A sample size of 255 patients was calculated. Statistical analysis. Odds Ratio (OR) and 95% confidence intervals (95% CI) were calculated for bivariate and multivariate analyses. Results: among 241 patients, the incidence of hyperchloremia was 12.4% (n = 30), and of hypernatremia 18.6% (n = 45). The frequency of AKI was 35.6%, and mortality was 14.1%. In logistic regression analysis, hypernatremia was associated with AKI (OR 2.7, 95% CI 1.3-5.7, p < 0.006), but not with mortality. While hyperchloremia was not identified as a risk for AKI or death. Conclusions: hyperchloremia and hypernatremia are common in critically ill pediatric patients, but only hypernatremia seems to confer a higher risk of complications. [ABSTRACT FROM AUTHOR]

Background: sodium disorders are the most common and least understood in patients with acute brain injury due to the major role played by the central nervous system in regulating sodium and water homeostasis, which can lead to serious complications and adverse outcomes, including death. Objective: to determine the hypernatremia contribution to mortality in patients with neurological conditions in critical state. Methods: longitudinal analytical observational study on 55 patients who were admitted to the acute care units at the Arnaldo Milián Castro University Hospital, between October 2020 and May 2022, regardless of the plasma sodium value upon admission to the service, as well as during their stay in the critical care units. Univariate and bivariate statistical methods were used in data analysis. Results: the average age was 60 ± 16 years. The most relevant diagnoses were intraparenchymal hemorrhage (56.37%), head trauma, and ischemic stroke (both 30%). Plasma sodium concentrations showed significant differences (pX2= 0.000), with the highest average at 24 hours of admission (174.2 ± 133.6) and the lowest at the 5th day (102.9 ± 72.9). There was a significant correlation between plasma sodium concentrations at admission, 24h and 72h with the state at discharge. In the individual bivariate analysis by period, there was only a significant relationship after 24 hours. In this period, hypernatremia contributed 1.78 times more to mortality than in those who did not have elevated sodium (OR=1.78 with CI: 1,39-3,4). Conclusions: hypernatremia in critically ill patients with neurological conditions is associated with increased mortality. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Coronavirus disease 2019 (COVID-19) has provoked one of the greatest health crises of our time, which is why risk stratification at the time of hospitalization is essential to identify in good time patients with high morbidity and mortality risk. Dysnatremia as an independent predictor of mortality in patients with COVID-19 has recently become relevant. Objective: To find out if there is an association of dysnatremia with 28-day mortality, and as secondary objectives, its association with hospital stay, invasive mechanical ventilation (IMV) requirement and presence of acute kidney injury (AKI) during hospital stay. Material and methods: Retrospective, descriptive and analytical cohort study. All consecutive patients of 16 years or older of any gender, admitted to a third level hospital from March 1, 2020 to March 2021, who have a diagnosis of COVID- 19 with positive PCR were included. Results: The study included a total of 722 patients. The prevalence of dysnatremia was as follows: 18 patients presented hypernatremia (2.49%) and 153 hyponatremia (21.19%). The presence of hypernatremia once sodium was corrected for glucose was associated with higher mortality (p < 0.05, OR 3.446; 95% CI 1.776-6.688), an increased probability of presenting AKI (p <0.05, OR 2.985; 95% CI 1.718-5.184) and a greater requirement for IMV (p < 0.05, OR 1.945; 95% CI 1.701-5.098). Conclusions: Hypernatremia was associated with higher mortality, higher risk of presenting AKI and the requirement for IMV during hospitalization. [ABSTRACT FROM AUTHOR]

BACKGROUND: Hypernatremic dehydration is observed in newborn with unsuccesfully lactaction, due to unbalanced water and electrolytes. Different methods to correct it, can cause complications. Since 2010, we use a standarized method to treat hipernatremia in infant newborns. AIM: To compare neurologic adverse outcome in newborn with hipernatremia in two different periods; before and after to use standarized treatment. METHODS: Retrospective, observational, cross-sectional and comparative study: before-after design, in neonates with hypernatremia treated with institutional standarized method. Clinical records of newborns between 2001 and 2021 with hipernatremia were reviewed. Group 1 (before) with patients from 2001 to 2010; 2011 was the implementation year and second group (after) from 2012 to 2021. Demographic, clinic, biochemical and treatment variables were obtained. χ2 and t test were used to compare outcomes between both groups. RESULTS: 242 cases were included: 79 in first group and 158 in second group. Five patients were not included in comparation because were treated in implementation year. Serum cretinine was different between groups: 3.6 mg/dl in group 1, and 2.5 mg/dL in second group (p=0.02); lost weight and serum sodium were similar. We found less neurologic anormalities, anormal EEG and combined adverse outcome at discharge in second group. CONCLUSION: Standarized treatment of neonatal hipernatremia allowed reduce neurologic adverse outcomes in infant newborn. [ABSTRACT FROM AUTHOR]

The migration phenomenon is increasingly common worldwide. It is essential for radiologists to be aware of the endemic diseases of the migrant's country as well as the characteristics of the journey to be able to understand and interpret radiological findings when admitted to our centre. This article aims to use imaging from our centre to describe the most common pathologies that migrant patients present with after long journeys by boat., (Copyright © 2024 SERAM. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Adipsic diabetes insipidus is a rare condition secondary to injury to osmoreceptors in the anterior hypothalamic area. Only two cases have been published secondary to pituitary tumor surgery. Case report: A 43-year-old man, postoperative of a non-functioning pituitary macroadenoma invading the third ventricle and compressing the hypothalamus. Reoperated for headache and rhinorrhachia, developing diabetes insipidus in the postoperative period was discharged with 20 µg/day nasal desmopressin. He came again due to sensorial disorder and hypernatremia, managing to control with intravenous hydration and desmopressin. It presents with recurrence of hypernatremia every time intravenous hydration is suspended and taken orally. With high sodium levels, there is an absence of thirst. A diagnosis of adipsic diabetes insipidus is made, indicating supervised administration of water orally with favorable evolution. Conclusions: Adipsic diabetes insipidus is a rare variant of central diabetes insipidus caused by damage to osmoreceptors in the hypothalamus. It manifests with absence of perception of thirst, hypernatremia and polyuria. Its management is complex and requires strict control of the water balance and adherence to treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Glucose changes are unknown in neonatal dehydration with hypernatremia. OBJECTIVE: Was to investigate glucose status in neonatal hypernatremic dehydration (NHD) and its correlation with NHD prognosis. MATERIAL AND METHODS: In this cohort study, serum glucose of 172 neonatal hypernatremic dehydration infants admitted to the Ghaem Hospital in Mashhad, Iran, was reviewed within the time frame of 2012 to 2017. The data were collected utilizing a questionnaire designed by the researchers to describe the characteristics of the mothers and neonates, as well as their laboratory and imaging study results. The neonatal hypernatremic dehydration infants were followed using the Denver Developmental Test II (DDT II) questionnaire at follow-up months 6, 12, 18, 24, 30, and 36. RESULTS: 134 infants (77.91%) had normal blood glucose levels and 38 infants (22.09%) had a hyperglycemic status. In both groups, the differences in infant age (p = 0.000), weight upon admission (p = 0.035), breastfeeding duration (p = 0.003), frequency of urination (p = 0.001), blood sugar (p = 0.000), sodium (p = 0.008), urea (p = 0.000), creatinine (p = 0.000), and pH upon admission (p = 0.002) were statistically significant. Developmental delays were higher in the neonatal hypernatremic dehydration group with hyperglycemia (p = 0.029). There was a significant correlation between sodium levels and blood sugar (p = 0.000). CONCLUSION: According to our study results, hyperglycemic neonatal hypernatremic dehydration infants had an older referral age; higher sodium, urea, and creatinine levels; lower weight upon admission; shorter breastfeeding duration; lower frequency of urination; and lower blood pH. Therefore, checking the blood sugar of infants with hypernatremia is recommended and high serum glucose is a poor prognosis criterion in infants with neonatal hypernatremic dehydration. [ABSTRACT FROM AUTHOR]

Copyright of Polish Nephrology & Dialyzotherapy / Nefrologia i Dializoterapia Polska is the property of Wydawnictwo Przegld Lekarski / Publisher Medicine Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Hypernatremia and rhabdomyolysis are clinical entities that are associated separately with mortality and hospital complications. Its combined presentation is infrequent and multiple etiologies have been described. CLINICAL CASE: An 18-year-old male patient who had severe hypernatremia associated with rhabdomyolysis secondary to haloperidol complicated by a neuroleptic malignant syndrome. CONCLUSIONS: Rhabdomyolysis-hypernatremia is an infrequent clinical illness requiring the individual approach of each case for its corresponding treatment. [ABSTRACT FROM AUTHOR]

Copyright of Jornal de Pediatria is the property of Sociedade Brasileira de Pediatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A hemorragia subaracnoidea é uma causa importante de morbidade e mortalidade. O objetivo do estudo foi determinar os preditivos de mortalidade entre os pacientes com hemorragia subaracnoidea internados em uma Unidade de Terapia Intensiva. Estudo retrospectivo de pacientes com hemorragia subaracnoidea internados na Unidade de Terapia Intensiva de nossa instituição de 2009 a 2015. Os dados foram coletados do banco de dados eletrônico da Unidade de Terapia Intensiva e de revisões dos prontuários dos pacientes. Incluímos no estudo 107 pacientes com hemorragia subaracnoidea. A ruptura de aneurisma foi a causa da hemorragia subaracnoidea em 76 pacientes (71%). A mortalidade geral foi de 40% (43 pacientes) e esteve significativamente associada ao choque séptico, desvio da linha média na tomografia computadorizada, transferência inter‐hospitalar, pneumonia por aspiração e hipernatremia durante as primeiras 72 horas de internação na Unidade de Terapia Intensiva. A análise multivariada dos pacientes com hemorragia subaracnoidea pós‐ruptura de aneurisma revelou que a mortalidade esteve significativamente associada ao choque séptico e hipernatremia nas primeiras 72 horas de permanência na Unidade de Terapia Intensiva, enquanto o tratamento precoce do aneurisma (clipagem ou embolização endovascular) nas primeiras 72 horas foi identificado como preditivo de um bom prognóstico. Os pacientes com hemorragia subaracnoidea transferidos apresentaram taxas menores de sobrevivência. Choque séptico e hipernatremia foram complicações importantes entre os pacientes gravemente enfermos com hemorragia subaracnoidea e foram associados ao aumento da mortalidade. Subarachnoid haemorrhage is an important cause of morbidity and mortality. The aim of the study was to determine predictors of mortality among patients with subarachnoid hemorrhage hospitalized in an Intensive Care Unit. This is a retrospective study of patients with subarachnoid hemorrhage admitted to the Intensive Care Unit of our institution during a 7 year period (2009–2015). Data were collected from the Intensive Care Unit computerized database and the patients' chart reviews. We included in the study 107 patients with subarachnoid haemorrhage. A ruptured aneurysm was the cause of subarachnoid haemorrhage in 76 (71%) patients. The overall mortality was 40% (43 patients), and was significantly associated with septic shock, midline shift on CT scan, inter‐hospital transfer, aspiration pneumonia and hypernatraemia during the first 72 hours of Intensive Care Unit stay. Multivariate analysis of patients with subarachnoid hemorrhage following an aneurysm rupture revealed that mortality was significantly associated with septic shock and hypernatremia during the first 72 hours of Intensive Care Unit stay, while early treatment of aneurysm (clipping or endovascular coiling) within the first 72 hours was identified as a predictor of a good prognosis. Transferred patients with subarachnoid haemorrhage had lower survival rates. Septic shock and hypernatraemia were important complications among critically ill patients with subarachnoid haemorrhage and were associated increased mortality. [ABSTRACT FROM AUTHOR]

Antecedentes y objetivos: Historicamente la deshidratación se ha asoaciado como un factor de riesgo y de deselnace funcional en la trombosis venosa cerebral sin embargo no existen parametros clínicos o bioquímicos para definir el estado de deshidratación, ni su relacion con el pronostico o recanalización. Metodos: Se llevó a cabo un estudio retrospectivo transversal de pacientes con diagnóstico de trombosis venosa cerebral (TVC) en el Instituto Nacional de Neurología y Neurocirugía en México. La selección de pacientes se realizó desde enero de 2015 hasta enero de 2022. La deshidratación se evaluó mediante la obtención del cociente BUN/creatinina >15, sodio > 145mEq y hematocrito > 45%. Se realizó una regresión lineal univariante y un modelo de regresión multivariante para evaluar la relación entre el cambio de BUN/Cr, sodio y hematocrito al momento del diagnostico de la TVC y los resultados de recanalización a 6 meses. Resultados: Se incluyeron 59 pacientes, 17 hombres (28.81%) y 41 mujeres (71.18%), con una edad promedio 43 años (+/-17). Después de ajustar los posibles factores de confusión, el análisis de regresión multivariable reveló que las asociaciones entre el aumento de BUN/Cr (OR 2.25), hipernatremia (OR 1.04) y hematocrito (OR 1.57), se relacionan con ausencia de recanalizacion (P <0,05) a los 6 meses. Conclusión: El aumento de BUN/Cr, hipernatremia y aumento del hematocrito en el momento de diagnostico de la TVC se correlaciona negativamente con recanalizacón a 6 meses. [ABSTRACT FROM AUTHOR]

La disnatremia (hiponatremia e hipernatremia) es frecuente en los pacientes que se encuentran en la unidad de cuidados intensivos (UCI) y puede aparecer durante su estadía. El objetivo de este trabajo fue presentar y discutir el caso clínico de un paciente adulto quien posterior a un accidente de tránsito es llevado a UCI, con hipernatremia persistente secundaria al tratamiento farmacológico y nutricional. El caso se trata de un paciente masculino de 36 años de edad quien es ingresado a la UCI posterior a presentar traumatismo craneoencefálico. Durante su estadía presenta trastornos hidroelectrolíticos, entre ellos hipernatremia persistente. Desde el momento de su ingreso se inicia hidratación con solución hipertónica, soporte nutricional parenteral y enteral. Tras 11 días en UCI con hipernatremia el grupo realiza una reunión con sus tratantes decidiendo hacer uso de un nuevo esquema de nutrición y utilizar agua libre de sodio. Luego de los cambios comenzó la mejoría del paciente y las cifras de sodio disminuyeron. La hipernatremia está asociada a un mal pronóstico; es más frecuente que aparezca en los pacientes durante su estadía en UCI debido al contenido de sodio en infusiones intravenosas, soluciones hipertónicas, el uso de diuréticos e hidrocortisona que pueden desencadenar hipernatremia iatrogénica. La hipernatremia es una condición que puede ser prevenida y tratada rápidamente en los pacientes críticos, a través de un trabajo multidisciplinario, para minimizar el tiempo de estadía en UCI y en el centro hospitalario, reduciendo así los costes de tratamiento y una curación más rápida del paciente.

ABSTRACT OBJECTIVE: To compare two electrolyte maintenance solutions in the postoperative period in children undergoing appendectomy, in relation to the occurrence of hyponatremia and water retention. METHODS: A randomized clinical study involving 50 pediatric patients undergoing appendectomy, who were randomized to receive 2,000 mL/m2/day of isotonic (Na 150 mEq/L or 0.9% NaCl) or hypotonic (Na 30 mEq/L NaCl or 0.18%) solution. Electrolytes, glucose, urea, and creatinine were measured at baseline, 24 h, and 48 h after surgery. Volume infused, diuresis, weight, and water balance were analyzed. RESULTS: Twenty-four patients had initial hyponatremia; in this group, 13 received hypotonic solution. Seventeen patients remained hyponatremic 48 h after surgery, of whom ten had received hypotonic solution. In both groups, sodium levels increased at 24 h (137.4 ± 2.2 and 137.0 ± 2.7 mmol/L), with no significant difference between them (p = 0.593). Sodium levels 48 h after surgery were 136.6 ± 2.7 and 136.2 ± 2.3 mmol/L in isotonic and hypotonic groups, respectively, with no significant difference. The infused volume and urine output did not differ between groups during the study. The water balance was higher in the period before surgery in patients who received hypotonic solution (p = 0.021). CONCLUSIONS: In the post-appendectomy period, the use of hypotonic solution (30 mEq/L, 0.18%) did not increase the risk of hyponatremia when compared to isotonic saline. The use of isotonic solution (150 mEq/L, 0.9%) did not favor hypernatremia in these patients. Children who received hypotonic solution showed higher cumulative fluid balance in the preoperative period.

La deshidratación hipernatrémica neonatal (DHN) es una enfermedad grave y se asocia con edema cerebral, hemorragia intracraneal y gangrena. El manejo de estos pacientes es controvertido por las complicaciones que se han reportado si la corrección de la natremia se lleva a cabo rápidamente. Se propone un protocolo para disminuir lentamente el sodio sérico. Metodología: Estudio prospectivo que incluyó a pacientes con Na sérico >150 mEq. Se manejaron con una carga rápida de solución salina y soluciones de rehidratación con 50 mEq de Na/L y glucosa al 5%. Se monitorizó el Na sérico a las 12 y las 24 horas. Resultados: Se ingresaron al estudio 51 pacientes, con una incidencia identificada de 10.2 casos por 1,000 recién nacidos vivos. El promedio de Na en el momento del ingreso fue de 158 mEq/l. El promedio de disminución de Na en las primeras 12 horas fue de 0.53 ± 0.08 mEq/l/h. En las siguientes 12 horas fue de 0.46 ± 0.09 mEq/l/h. No se presentaron alteraciones neurológicas en ningún paciente. Conclusiones: La rehidratación en el neonato con DHN con una o dos cargas de solución salina al 0.9% y el posterior manejo con soluciones con 50 mEq/l de Na y solución glucosada al 5% (“tercio normal”) fueron seguros para descender lentamente los niveles séricos de Na, aproximadamente, a 0.5 mEq/h.

Copyright of Scientia Medica is the property of EDIPUCRS - Editora Universitaria da PUCRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hipernatremia é um distúrbio hidro-eletrolítico frequente em pessoas nas quais o mecanismo da sede ou o acesso à água está comprometido podendo causar desde morbidades mínimas até coma. Entre as morbidades causadas pela hipernatremia, a hemorragia do sistema nervoso central é infreqüente e pouco estudada. Relatamos um caso de paciente admitido na unidade de terapia intensiva com redução do nível de consciência, hipernatremia e tomografia computadorizada de crânio evidenciando hemorragia intraparenquimatosa bilateral. Foi realizada revisão de literatura de encefalopatia hemorrágica hipernatrêmica.Hypernatremia is a common electrolyte disorder in people with impaired thirst control mechanism or access to water, and may lead from minimal disorders until coma. Among the hypernatremia morbidities, central nervous system hemorrhage is uncommon and poorly studied. We report a case involving a patient admitted to the intensive care unit with reduced consciousness level, hypernatremia and head computed tomography scan showing bilateral parenchyma hemorrhage. A literature review of hypernatremia hemorrhagic encephalopathy was conducted.

BACKGROUND: Disorders of water and sodium balance are frequently seen in patients with severe brain injury (SBI), and may worsen their prognosis. PURPOSE: To evaluate vasopressin (AVP) serum levels and sodium and water balance disorders during the first week post-injury in patients with SBI. METHOD: Thirty-six adult patients with SBI (admission Glasgow Coma Scale score < 8) and an estimated time of injury < 72 hours were prospectively studied. Clinical and laboratory data were recorded and AVP was measured in venous blood samples collected on the 1st, 2nd, 3rd and 5th days following inclusion. RESULTS: AVP serum levels remained within the normal range in SBI patients (either traumatic or non-traumatic), although tended to be greater in non-survivor than in survivor patients (p=0.025 at 3rd day). In-hospital mortality was 43% (15/36), and serum sodium and plasma osmolality variabilities were greater in non-survivor than in survivor patients during the observation period (pANTECEDENTES: Desordens do balanço de água e sódio são frequentemente vistas em pacientes com lesão cerebral grave (LCG), podendo agravar o prognóstico. OBJETIVO: Avaliar os níveis séricos de vasopressina (AVP) e a incidência de distúrbios da água e sódio na primeira semana pós-lesão em pacientes com LCG. MÉTODO: Trinta e seis pacientes adultos com LCG (pontuação inicial na escala de coma de Glasgow < 8) e tempo estimado de lesão < 72h foram estudados prospectivamente. Dados laboratoriais e clínicos foram registrados e os níveis séricos de AVP foram mensurados no 1º, 2º, 3º e 5º dias pós-inclusão. RESULTADOS: A AVP manteve-se dentro da faixa de normalidade nestes pacientes, mas mostrando-se proporcionalmente mais elevada nos pacientes que não sobreviveram (p=0,025 no 3º dia). A mortalidade intra-hospitalar foi 43% (15/36) e as variações do sódio e osmolalidade plasmáticos foram maiores nos pacientes que não sobreviveram durante o período de observação (p

Objectives: To identify variables associated with hypernatremia in adult patients admitted in an internal medicine service in a general hospital in Lima, Peru. Methods: Case-control study of patients admitted in the Internal Medicine service of Hospital Cayetano Heredia during 2013. A sample size of 65 cases and controls, matched by date of admission and Glasgow coma scale, to obtain an OR of 3 with 80% power and 95% confidence was estimated. Results: Hypernatremia was associated with fever (p=0.013); tachypnea (p=0.030); level of consciousness (p=0.032); use of diuretics (p=0.017); presence of diarrhea (p=0.045) and use of hypertonic solutions (p<0.0001). Acute renal failure and sepsis showed association in the univariate analysis but not in the logistic regression analysis. Conclusions: This study showed that fever, tachypnea, level of consciousness, use of diuretics, diarrhea and use of hypertonic solutions were relevant to develop hospital-acquired hypernatremia. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Jornal de Pediatria is the property of Sociedade Brasileira de Pediatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Sodium is the most abundant extracellular cation and has a normal serum concentration of 135 to 145 meq/L. Normal homeostatic mechanisms keep the serum sodium concentration and serum osmolality within narrow therapeutic ranges. Sodium imbalances are common in inbed patients, and caution must be exercised to avoid inappropriate correction, which could result in further complications, morbidity, and death. A quick formula is proposed for simplification of the calculations for correction or sodium imbalances.

Introduction: Salt (NaCl) is a chemical compound widely used in everyday life and in a number of medical procedures. Case report: The paper presents a case of unintentional fatal poisoning with saltwater, resulting from improperly provided first aid in a subject who attempted suicide (overdose of medication), and consulted by forensic experts for potential medical malpractice. A 34-year-old woman drank about 10 glasses of water (2500 mL) with a significant amount of salt. There was no subsequent vomiting, but at first severe water-electrolyte imbalance (severe hypernatremia) occurred and, consequently, multiple intracranial haematomas formed, ultimately leading to death. Conclusion: This case illustrates the still existing lack of adequate awareness of the causes and consequences of severe water-electrolyte imbalance which may result from incorrect attempts to treat acute poisoning. [ABSTRACT FROM AUTHOR]

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Pontine myelinolysys is a disease with high mortality rate of up to 80%, and 20% who survive remain with permanent neurological sequelae. In patient With hyponatremia hipertonica solutions bad replacement is de main cause of this desease, it is believed that rapid correction of hypernatremia with hypotonic solution can cause this syndrome,which is characterized by disturbances of consciousness dysphagia, dysarthria, mutism and reto bulbar palsy and tetraparesis. It is important to properly restore solutions in patients with hipernatremia and make frequent checks of this ion since this dependends on of our patient with the advent of technology diagnostic imaging is performaed with high accuracy, as well as markers cer broespinal fluid, guiding us if demyelination is inminent, before starting de correction of electrolyte. We found it interesting to report this case to discuss the treatment of our patients and know and prevent this. We report a case of 75 year old, who was admitted to the ICU with a diagnosis of metabolic encephalopathy secondary to severe dehydration and hipernatremia severe, mielinolisis extrapontina present despite adequate fluid and electrolyte replacement, initially diagnostic by clinical and subsequently supplemented with neuroimaging studies. [ABSTRACT FROM AUTHOR]

The hyperosmolar state is more common in patients with DM of long duration; however, can also occur hyperosmolar state (HS) with blood glucose below 600 mg/dL, by raising the concentration of sodium and worse, a combination of both, who have a worse prognosis. Objectives: To study the clinical course of patients with hyperosmolar state and to know if it's worse the outcome of patients with HS if it's associated with elevation of serum sodium. Methods: We used a cross-sectional analytical study, patients over 18 year old were admitted to the Emergency Service, having been diagnosed with hyperosmolar state (osmolarity measurement greater than 320 mOsm/kg) to which they assessed the hydric state, neurological status as well as serum sodium, glucose and BUN. Results: We studied 70 patients, 37 (52.9%) men and 33 women, mean age were 53.74 years. Sodium income was 132.48 ± 10.6 mEq/L, glucose of 788.59 ± 221.55 mg/dL, BUN of 40.26 ± 26.36. Two thirds (66.2%) were admitted with hyperglycemic hyperosmolar state. Sodium corrected average was 143.81 ± 10.77, the average effective osmolarity was 331.67 ± 27.96 and calculate osmolarity was 344.29 ± 30.85 with a anion gap of 26.71 ± 15.73. Only eight patients died, all associated with a serious disease, we was found that the higher sodium and osmolarity calculated was higher on deseased patients (p = 0.05 and 0.02 respectively), also a higher sodium than 150 mEq/L was a factor a poor prognosis (9.8 95%, CI 1.99-48.43). Conclusions: Hypernatremia is a poor prognostic factor in patients with hyperosmolar state, mortality was 11.4%. The hypernatremic hyperosmolar state should be considered as a worse case than hyperglycemic hyperosmolar state. [ABSTRACT FROM AUTHOR]

Hypernatremia defined as a rise in the serum sodium concentration to value exceeding 145 mmol per liter. The main cause of hypernatremia is the loss of fluid containing low sodium concentration and replacement with fluid containing high sodium concentration. Neurologic signs and symptoms are more common in adults. Hypernatremia initially causes fluid movement out of the brain there is rapid uptake of electrolytes that minimizes the decrease in brain volume, this is followed by a slower adaptive phase within 1 to 3 days. The rate of correction most be addressed when plasma sodium concentration is correct, since rapidly lowering the plasma sodium concentration causes osmotic water movement into the brain, cerebral edema, can then lead to seizures, permanent neurologic damage or death. Hypernatremia is common in hospitalized patients as an iatrogenic condition and is associated with increased risk of hospital mortality. [ABSTRACT FROM AUTHOR]

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Polyuria is a common clinical condition characterized by a urine output that is inappropriately high (more than 3 L in 24 h) for the patient's blood pressure and plasma sodium levels. From a pathophysiological point of view, it is classified into two types: polyuria due to a greater excretion of solutes (urine osmolality >300 mOsm/L) or due to an inability to increase solute concentration (urine osmolality <150 mOsm/L). Sometimes both mechanisms can coexist (urine osmolality 150-300 mOsm/L). Polyuria is a diagnostic challenge and its proper treatment requires an evaluation of the medical record, determination of urine osmolality, estimation of free water clearance, use of water deprivation tests in aqueous polyuria, and measurement of electrolytes in blood and urine in the case of osmotic polyuria., (Copyright © 2021 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.)