Comparison of the incidences of hyponatremia in adult postoperative critically ill patients receiving intravenous maintenance fluids with 140 mmol/L or 35 mmol/L of sodium: retrospective before/after observational study

Okada, Masako; Egi, Moritoki; Yokota, Yuri; Shirakawa, Naotaka; Fujimoto, Daichi; Taguchi, Shinya; Furushima, Nana; Mizobuchi, Satoshi

doi:10.1007/s00540-017-2370-y

Cited by 7 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The alternation of maintenance fluid would affect to blood glucose level as well [5]. Our study revealed that there was significant association of the incidence of hyponatremia with delirium, but not blood glucose level.…”

Section: Discussionmentioning

confidence: 54%

“…This study is to explore the impact of the select of postoperative maintenance fluid on the postoperative delirium as patients' centered outcome following the previous study [5] with new protocol and fresh ethics approval. Accordingly, some of included patients were overlapped with previous study [5]. The Kobe University Hospital Ethics Committee approved this investigation (No 180026, approved on April 20, 2018).…”

Section: Methodsmentioning

confidence: 99%

“…However, the use of hypotonic fluids has been reported to be associated with an increased risk of postoperative hyponatremia [5]. Then, it is known that hyponatremia is one of risk factors of postoperative delirium [6].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients: retrospective before-after observational study

et al. 2019

Self Cite

View full text Add to dashboard Cite

To assess the impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients, we conducted retrospective before-after study in a tertiary teaching hospital. Methods:We examined all adult patients admitted ICU after an elective operation for head and neck cancer, or esophageal cancer from February 2014 to January 2017. From February 2014 to July 2015, patients were administered hypotonic fluid (sodium; 35 mmol/L) as the National Institute for Health and Care Excellence (NICE) have recommended. From August 2015 to January 2017, patients were administered isotonic fluid (sodium; 140 mmol/L). We defined the incidence of delirium as the primary outcome. The delirium was defined as the Intensive Care Delirium Screening Checklist during the ICU stay ≥4. A propensity score-matched model was used to adjust confounders. Results:As postoperative intravenous maintenance fluid, hypotonic fluid was administered to 119 patients and isotonic fluid was administered to 92 patients.Among those total cohorts, the incidence of postoperative delirium in the hypotonic group was 21.8%, which was significantly higher than that (9.8%) in the isotonic group (p=0.019). After propensity score matching, we selected 77 patients in each group. The incidence of delirium during the ICU stay in the hypotonic group was 26.0%, which was significantly higher than the incidence of 11.7% in the isotonic group (p=0.023). Conclusions:In this study, the use of postoperative hypotonic maintenance fluid was associated with a higher risk of postoperative delirium than that when isotonic maintenance fluid was used.

show abstract

Section: Discussionmentioning

confidence: 54%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients: retrospective before-after observational study

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…11 12 A recent study of postoperative adults demonstrated that the incidence of hyponatraemia could be decreased from 51% to 16% by using an isotonic solution in favour of a hypotonic solution. 13 In the recently published SPLIT trial, over 2000 adults in the intensive care unit received isotonic fluids, and there was no evidence that this approach was unsafe. 14 Regenmortel and colleagues suggested that isotonic fluids are associated with decreased urine output and a higher chloride concentration.…”

Section: Declaration Of Interestmentioning

confidence: 99%

Hypotonic maintenance i.v. fluids are not appropriate in acutely ill patients. Conclusions can't be extrapolated from healthy volunteers

Moritz

Ayus

2017

British Journal of Anaesthesia

View full text Add to dashboard Cite

“…We believe the pediatric evidence should be extrapolated and included with the supporting (albeit limited) adult evidence, and that when indicated, isotonic fluids should be the maintenance fluid for most hospitalized adults. [3][4]6…”

mentioning

confidence: 99%

Not Salty Enough

Hall¹,

Ayus²,

Ayach³

et al. 2019

Journal of Hospital Medicine

View full text Add to dashboard Cite

Comparison of the incidences of hyponatremia in adult postoperative critically ill patients receiving intravenous maintenance fluids with 140 mmol/L or 35 mmol/L of sodium: retrospective before/after observational study

Abstract: In this study, the use of intravenous maintenance fluid with 35 mmol/L of sodium was significantly associated with an increased risk of hyponatremia compared to that with 140 mmol/L of sodium in adult postoperative critically ill patients.

Cited by 7 publications

References 20 publications

The impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients: retrospective before-after observational study

The impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients: retrospective before-after observational study

Hypotonic maintenance i.v. fluids are not appropriate in acutely ill patients. Conclusions can't be extrapolated from healthy volunteers

Not Salty Enough

Contact Info

Product

Resources

About