Document Detail

Dysnatremias: why are patients still dying?
MedLine Citation:
PMID:  16634244     Owner:  NLM     Status:  MEDLINE    
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.
Steven G Achinger; Michael L Moritz; Juan Carlos Ayus
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Southern medical journal     Volume:  99     ISSN:  0038-4348     ISO Abbreviation:  South. Med. J.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-25     Completed Date:  2006-05-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404522     Medline TA:  South Med J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  353-62; quiz 363-4     Citation Subset:  AIM; IM    
Division of Nephrology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA.
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MeSH Terms
Ambulatory Care
Brain Diseases, Metabolic / diagnosis,  etiology,  physiopathology,  therapy
Demyelinating Diseases / physiopathology,  prevention & control
Hypernatremia / diagnosis,  etiology,  physiopathology*,  therapy*
Hyponatremia / diagnosis,  etiology,  physiopathology*,  therapy*
Postoperative Complications
Risk Factors
Water-Electrolyte Balance / physiology

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