Summary:We report a retrospective study of hypernatraemia (serum sodium concentration > 150 mmol/l) in an adult in-patient population of a health district during one year. The incidence was 0.3% with at least 60% of cases developing after hospital admission, mainly in elderly patients. Dehydration appeared to be the major cause, with the use of diuretics, depressed conscious level or febrile illness implicated in a majority. Most patients had more than one contributory factor and iatrogenic causes were common. Associated illnesses were often severe and the in-hospital mortality was high (54%) regardless of age. Hypernatraemia in hospitalized patients should be largely avoidable and there is a need for greater awareness of the importance of active maintenance of hydration in susceptible patients.

Summary:Decisions concerning the use of intravenous fluids and antibiotics in terminally ill patients are regularly made by hospital doctors, but there is little record of staff attitudes and current practice in Britain. A The results suggest that British doctors are divided in their approach to the medical management of terminally ill patients and there is a need for greater discussion and training so that all the issues involved are fully appreciated.

No abstract

No abstract