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Hyponatremia accompanied by normovolemia among the patients of Anesthesiology and Intensive Care Unit. Incidence and causes

Monika Tomasik, Anna Samborska-Sablik, Wojciech Gaszyński, Zbigniew Sablik, Karol Pietrzyk

Med Sci Tech 2007; 48(2): RA117-120

ID: 881556


Introduction: Hyponatremia is an important problem but it is often underestimated. Clinical symptoms are diagnosed when the level of sodium falls [Na+] ≤ 125 mmol/L. When the concentration of sodium is Na < than 115 mmol/L brain edema emerges. One of the causes of hyponatremia with normovolemia is the syndrome of inappropriate anti-diuretic hormone secretion (SIADH). The objective of the research is to state the incidence of hyponatremia ≤ 125 mmol/L which is accompanied by normovolemia among the patients of Anesthesiology and Intensive Care Unit. Material and Methods: The retrospective evaluation was made on the basis of the ICU documentation (Anesthesiology and Intensive Care Unit of Norbert Barlicki Memorial Teaching Hospital No 1). Case histories of 520 patients hospitalised in 2005-2006 were analysed. The patients with the level of Na≤ 125 mmol/L qualified for a detailed examination. Results: 27 people (5,2%) had the level of sodium ≤ 125mmol/L. 5 people (18,5%) displayed the clinical symptoms of SIADH. 12 (44,4%) patients developed normovolemia. 4 people (14,8%) suffered from SIADH. 4 patients (14,8%) exhibited the symptoms of SIADH, but they had taken a diuretic drug during the treatment. In the group consisting of both the patients with SIADH and those with SIADH symptoms who had been taking diuretic drug during the treatment, 4 patients (50%) developed the disease as a result of nervous system and lungs diseases; 2 of them (25%) suffered from a nervous system disease, and the other 2 suffered from a disease of the lungs. 3 people (75%) out of the group of the 4 patients (14,8%) with SIADH died. Conclusions: 1) Na was ≤ 125 mmol/L in the case of 5,2% of the examined people. 2) 44,4% of the patients were diagnosed with hyponatremia accompanied by normovolemia. 3) The causes of SIADH in the studied group of patients were nervous system or lungs diseases. 4) The hospitalisation of 75% patients with SIADH and 25% of those with SIADH symptoms who had been taking diuretic ended with death. (Clin Exp Med Lett 2007; 48:2: 117-120)

Keywords: Hyponatremia, normovolemia, syndrome of inappropriate anti-diuretic hormone secretion

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