Search results for "natremia"
showing 10 items of 24 documents
The relation between the incidence of hypernatremia and mortality in patients with severe traumatic brain injury
2009
Introduction The study was aimed at verifying whether the occurrence of hypernatremia during the intensive care unit (ICU) stay increases the risk of death in patients with severe traumatic brain injury (TBI). We performed a retrospective study on a prospectively collected database including all patients consecutively admitted over a 3-year period with a diagnosis of TBI (post-resuscitation Glasgow Coma Score ≤ 8) to a general/neurotrauma ICU of a university hospital, providing critical care services in a catchment area of about 1,200,000 inhabitants. Methods Demographic, clinical, and ICU laboratory data were prospectively collected; serum sodium was assessed an average of three times per …
Effects of high-dose furosemide and small-volume hypertonic saline solution infusion in comparison with a high dose of furosemide as bolus in refract…
2003
Background Diuretics have been accepted as first-line treatment in refractory congestive heart failure (CHF), but a lack of response to them is a frequent event. A randomized, single-blind study was performed to evaluate the effects of the combination of high-dose furosemide and small-volume hypertonic saline solution (HSS) infusion in the treatment of refractory New York Heart Association (NYHA) class IV CHF and a normosodic diet during follow-up. Materials and Methods One hundred seven patients (39 women and 68 men, age range 65-90 years) with refractory CHF (NYHA class IV) of different etiologies, who were unresponsive to high oral doses of furosemide, angiotensin-converting enzyme inhib…
Late-onset Sheehan's syndrome presenting with rhabdomyolysis and hyponatremia: a case report.
2013
Abstract Introduction Hyponatremia associated with rhabdomyolysis is a rare event and a correct diagnostic approach is required to rule out this or other diseases as a primary cause and to avoid other complications resulting from a lack of appropriate treatment. Case presentation A 64-year-old Caucasian woman presented to our facility with worsening fatigue, slurred speech, nausea and vomiting, and high serum levels of creatine kinase and myoglobin together with hyponatremia. Normal arterial blood gas analysis results, normal serum potassium levels, increased urine sodium levels, urine specific gravity of >1003N/m3 and low urine volume suggested an endocrine etiology. Her low cortisol an…
Enfermedad del legionario con afectación hepática predominante
2002
Like other pneumonias due to atypical agents, pneumonia due to Legionela Pneumophila has no characteristic clinical facts, although fever and non-productive cough are almost constant and diarrhea with changes in mental status are common. Hyponatremia and moderate transient hypertransaminasemia are common too. Severe systemic affectation after hematogenous dissemination similar to those described with typical bacterial pneumonias is a prominent difference with other atypical agents, with high mortality rates in the absence of appropriate treatment. Etiological diagnosis is very difficult and it is normally achieved late in the course of the infection. Because of diagnostic difficulties and p…
A Rare Case of Water Intoxication in Unusual Chiropratic Prescription: A Medico-Legal Analysis Due to Alleged Malpractice.
2021
Introduction. Water intoxication is a well-recognized cause of symptomatic hyponatremia, whose often fatal consequences are described in a wide variety of conditions such as psychiatric disorders, metabolic dysfunctions, child abuse, drug abuse and several medical procedures. The case. We here report a rare case of a 67-year-old woman with severe acute hyponatremia due to an excessive voluntary water intake – 14 litres in two days – following a chiropractic prescription. The patient developed sudden severe symptoms, including water retention, sensory alteration, altered mental status and tonic-clonic seizures. She was thus admitted to the Intensive Care Unit with a diagnosis of coma due to …
Physiopathologica, epidemiologica, clinical and therapeutic aspects of exercise-associated hyponatriemia
2014
Exercise-associated hyponatremia (EAH) is dilutional hyponatremia, a variant of inappropriate antidiuretic hormone secretion (SIADH), characterized by a plasma concentration of sodium lower than 135 mEq/L. The prevalence of EAH is common in endurance (6 hours in duration), in which both athletes and medical providers need to be aware of risk factors, symptom presentation, and management. The development of EAH is a combination of excessive water intake, inadequate suppression of the secretion of the antidiuretic hormone (ADH) (due to non osmotic stimuli), long race duration, and very high or very low ambient temperatures. Additional risk factors include female gender, slower race times, and…
LE IPERNATRIEMIE NELL’ANZIANO
2015
L’pernatremia è caratterizzata da un deficit di acqua corporea totale rispetto al sodio ed è definita da una concentrazione plasmatica superiore a 145 mmol/L. L’ipersodiemia nella popolazione geriatrica è un disturbo comune, associato ad una significativa morbilità e mortalità. Le persone anziane sono predisposte a sviluppare ipernatriemia a causa di modificazioni fisiologiche legate all'età: ad esempio la diminuzione della sete, una ridotta capacità di concentrazione delle urine e la diminuzione del contenuto di acqua corporea totale. I farmaci possono aumentare questa predisposizione. Nelle case di cura e di riposo, l’ipernatremia e la disidratazione sono considerate prevenibili, per cui …
RENAL SALT WASTING: UNA SINDROME DA INAPPROPRIATA SECREZIONE DI URODILATINA? UNO STUDIO PILOTA
2022
La Renal Salt Wasting Syndrome (RSW) è una sindrome clinica con caratteristiche di laboratorio che si sovrappongono completamente alla sindrome da secrezione inappropriata di ADH (SIADH). La differenza fondamentale tra le due sindromi risiede nel volume extracellulare (ECV), ridotto nella RSW e normale o leggermente aumentato nella SIADH. Le difficoltà nella diagnosi differenziale di questa sindrome e nella comprensione del preciso meccanismo patogenetico hanno contribuito a mettere in discussione l'esistenza stessa di RSW. Considerando le caratteristiche della RSW, è stato studiato il possibile ruolo dei peptidi natriuretici per spiegare la sua patogenesi come ANP e BNP, con risultati inso…
Estudio de la concentración ideal de sodio en los fluidos intravenosos de mantenimiento en pediatría
2012
Introducción: La fluidoterapia intravenosa de mantenimiento se utiliza ampliamente en pediatría, bien en pacientes que no toleran toda la cantidad de fluidos que necesitan oralmente, que están sometidos a vigilancia para prevenir complicaciones de alguna patología, que no deben ingerir ningún alimento para la realización de alguna prueba o tras haber sido sometidos a cirugía. Sin embargo, la composición de estos fluidos ha sido escasamente estudiada y las recomendaciones se basan más en opiniones que en estudios científicos de su seguridad. En los últimos años, se ha publicado complicaciones secundarias a su concentración de sodio, requiriéndose en este momento un estudio que trate de aclar…
L’IPONATRIEMIA NELL’ANZIANO: UNA PROBLEMATICA SEMPRE ATTUALE
2015
Le alterazioni della concentrazione plasmatica del sodio rappresentano una delle disionie di più frequente riscontro nei pazienti ricoverati e che l’incidenza e la prevalenza aumentano con l’età. Molteplici fattori correlati all’invecchiamento giocano un ruolo in tal senso; ad esempio, variazioni anatomiche e funzionali, modificazioni della composizione corporea, alterazioni dei meccanismi fisiologici che regolano il metabolismo e l’omeostasi del sodio e dell’acqua. L’aumento dell’incidenza di tali disturbi nella popolazione anziana rappresenta un chiaro esempio di come l’invecchiamento è in grado di compromettere le capacità di compenso, di adattamento e l’omeostasi dell’organismo. Alterat…