Dysnatremias: why are patients still dying?

Southern Medical Journal
Steven G AchingerJuan Carlos Ayus

Abstract

Dysnatremias are a common clinical entity that are often associated with poor outcomes. This review takes a case study approach to understand how dysnatremias can result in devastating neurologic consequences. Concrete guidelines are provided for prevention, early recognition and treatment along with a discussion of how urinary electrolytes and osmolality can be used to guide therapy. Case studies in hyponatremic encephalopathy include the post-operative state, thiazide diuretics, extreme exercise and DDAVP use. Reasons to avoid using hypotonic parenteral fluids, risk factors for hyponatremic encephalopathy such as age, gender, and hypoxia, and the appropriate use of 3% sodium chloride are discussed. Case studies in hypernatremia include hypernatremia in the ICU setting and the emerging condition of breastfeeding-associated hypernatremia in infants.

References

Dec 1, 1992·Annals of Internal Medicine·J C AyusA I Arieff
Nov 5, 1987·The New England Journal of Medicine·J C AyusA I Arieff
Dec 1, 1973·The Journal of Clinical Investigation·F L DunnG L Robertson
May 1, 1970·The American Journal of Physiology·J A JohnsonW W Moore
Dec 20, 1994·Proceedings of the National Academy of Sciences of the United States of America·J S JungP Agre
Nov 9, 1995·The New England Journal of Medicine·M L McManusK Strange
Dec 15, 1993·Proceedings of the National Academy of Sciences of the United States of America·S NielsenH W Harris
Jan 15, 1996·Annals of Internal Medicine·P M PalevskyA Greenberg
Feb 1, 1996·Neurology·J C Ayus, A I Arieff
Apr 16, 1998·The American Journal of Forensic Medicine and Pathology·J A KaplanG A Schmunk
Jul 1, 1999·JAMA : the Journal of the American Medical Association·J C Ayus, A I Arieff
Sep 2, 1999·Pediatrics·M L Moritz, J C Ayus
Oct 3, 1999·Journal of Neurosurgery·S SgourosK Natarajan
Apr 29, 2000·Annals of Internal Medicine·J C AyusA I Arieff
Sep 26, 2002·Journal of Neurosurgery·Chris XenosKalyan Natarajan
Feb 4, 2003·Pediatrics·Michael L Moritz, Juan Carlos Ayus
Feb 15, 2003·BMJ : British Medical Journal·J Carlos AyusAllen I Arieff
Nov 8, 2003·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Michael L Moritz, J Carlos Ayus
Apr 15, 2005·The New England Journal of Medicine·Christopher S D AlmondDavid S Greenes
Jul 5, 2005·Pediatrics·Milton Tenenbein
Jul 9, 2005·Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine·Tamara Hew-ButlerUNKNOWN Exercise-Associated Hyponatremia (EAH) Consensus Panel
Sep 6, 2005·Pediatrics·Michael L MoritzJ Carlos Ayus

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Citations

Jun 27, 2007·Nature Clinical Practice. Nephrology·Michael L Moritz, Juan Carlos Ayus
Apr 2, 2009·Journal of Sports Sciences·Giles WarringtonDeclan Lyons
Dec 8, 2006·Seminars in Dialysis·Martin SedlacekBrian D Remillard
Mar 5, 2013·Journal of Infusion Nursing : the Official Publication of the Infusion Nurses Society·Rita Wunderlich
Mar 26, 2008·Anaesthesia and Intensive Care·A J HayangaL M Napolitano
Jul 14, 2017·Critical Care Medicine·Steven G Achinger, Juan Carlos Ayus
Oct 5, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Hashim K MohmandRichard H Sterns
Dec 7, 2007·Expert Review of Neurotherapeutics·Richard H SternsAmyn M Rojiani
Feb 1, 2012·Diabetic Medicine : a Journal of the British Diabetic Association·K DhatariyaUNKNOWN Joint British Diabetes Societies
Jun 16, 2009·Seminars in Nephrology·Richard H SternsJohn Kevin Hix

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