Hyponatremia in the emergency department

Lee, Chien Te; Guo, How‐Ran; Chen, Jin Bor

doi:10.1016/s0735-6757(00)90118-9

Cited by 83 publications

(61 citation statements)

References 19 publications

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“…Electrolyte imbalances are common findings in many diseases. [1,2] Imbalances in every electrolyte must be considered in a combined and associated fashion, and examinations must aim to clarify the clinical scenario for an effective and successful treatment. Most of important and prevailing electrolyte imbalances are hypo- and hyper-states of sodium, potassium, calcium, and magnesium.…”

Section: Introductionmentioning

confidence: 99%

General characteristics of patients with electrolyte imbalance admitted to emergency department

Balcı¹,

Köksal²,

Köse³

et al. 2013

World Journal of Emergency Medicine

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BACKGROUND:Fluid and electrolyte balance is a key concept to understand for maintaining homeostasis, and for a successful treatment of many metabolic disorders. There are various regulating mechanisms for the equilibrium of electrolytes in organisms. Disorders of these mechanisms result in electrolyte imbalances that may be life-threatening clinical conditions. In this study we defined the electrolyte imbalance characteristics of patients admitted to our emergency department.METHODS:This study was conducted in the Emergency Department (ED) of Uludag University Faculty of Medicine, and included 996 patients over 18 years of age. All patients had electrolyte imbalance, with various etiologies other than traumatic origin. Demographic and clinical parameters were collected after obtaining informed consent from the patients. The ethical committee of the university approved this study.RESULTS:The mean age of the patients was 59.28±16.79, and 55% of the patients were male. The common symptoms of the patients were dyspnea (14.7%), fever (13.7%), and systemic deterioration (11.9%); but the most and least frequent electrolyte imbalances were hyponatremia and hypermagnesemia, respectively. Most frequent findings in physical examination were confusion (14%), edema (10%) and rales (9%); and most frequent pathological findings in ECG were tachycardia in 24%, and atrial fibrillation in 7% of the patients. Most frequent comorbidity was malignancy (39%). Most frequent diagnoses in the patients were sepsis (11%), pneumonia (9%), and acute renal failure (7%).CONCLUSIONS:Electrolyte imbalances are of particular importance in the treatment of ED patients. Therefore, ED physicians must be acknowledged of their fluid-electrolyte balance dynamics and general characteristics.

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Section: Introductionmentioning

confidence: 99%

General characteristics of patients with electrolyte imbalance admitted to emergency department

Balcı¹,

Köksal²,

Köse³

et al. 2013

World Journal of Emergency Medicine

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“…Moreover, in other critically ill or emergency patient populations, both severe hyper-and hyponatremia are associated with persistent neurological deficits and high mortality [6][7][8]. Traditionally, patients with cerebral insults receive sodium chloride containing fluids (normal saline) for baseline and substitution requirements.…”

Section: Introductionmentioning

confidence: 99%

Randomized, Double-Blind Trial of the Effect of Fluid Composition on Electrolyte, Acid–Base, and Fluid Homeostasis in Patients Early After Subarachnoid Hemorrhage

et al. 2012

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Background Hyper-and hyponatremia are frequently observed in patients after subarachnoidal hemorrhage, and are potentially related to worse outcome. We hypothesized that the fluid regimen in these patients is associated with distinct changes in serum electrolytes, acid-base disturbances, and fluid balance. Methods Thirty-six consecutive patients with SAH were randomized double-blinded to either normal saline and hydroxyethyl starch dissolved in normal saline (Voluven Ò ; saline) or balanced crystalloid and colloid solutions (Ringerfundin Ò and Tetraspan Ò ; balanced, n = 18, each) for 48 h. Laboratory samples and fluid balance were evaluated at baseline and at 24 and 48 h. Results Age [57 ± 13 years (mean ± SD; saline) vs. Conclusions Treatment with saline-based fluids resulted in a greater number of patients with hyperchloremia, hyperosmolality, and positive fluid balance >1,500 mL early after SAH, while administration of balanced solutions did not cause more frequent hyponatremia or hypo-osmolality. These results should be confirmed in larger studies.

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“…Almost onethird of the patients have iatrogenic disease before hospital admission [20] and 3-7% of all admissions have iatrogenic causes [10,15,16,21,22], increasing to almost 8% in patients over 65 years of age [11]. Iatrogenic events are also an important cause of admission to intensive care units (ICUs) [23][24][25][26][27] and of hospital readmission [28,29]. Little epidemiological data is available [6,10].…”

Section: Introductionmentioning

confidence: 99%

The diseases we cause: Iatrogenic illness in a department of internal medicine

Madeira

Melo

Porto³

et al. 2007

European Journal of Internal Medicine

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Background: The aim of this study was to estimate the incidence, main causes, and risk factors of iatrogenic disease occurring in a department of internal medicine. Methods: Over a 1-year period, physicians systematically filled out a 2-page questionnaire for all patients admitted to the ward. A database was created and the data were statistically analyzed. Patients undergoing immunosuppressive, chemo-, or radiation therapy were excluded. Missing data were completed by reviewing the patients' charts. The patients were then divided into two groups: those with and those without iatrogenic disease. The groups were compared using several parameters including gender, age, social features, days of hospitalization, associated illness, functional status, medical impression, prognosis, associated renal or liver function impairment, drugs taken daily, and outcome. In the group with iatrogenic disease, the type, severity, and predictability were also analyzed. Results: Of the 879 patients admitted to the ward, 445 completed questionnaires and were included in the study. A total of 102 patients (22.9%) developed 121 iatrogenic events. Forty-four patients (43.1%) were admitted for iatrogenic illness, 10 (9.8%) developed lifethreatening events, and in 3 (6.8%) it was the cause of death. Fifty-eight patients (56.8%) registered 77 episodes of iatrogenic disease during their hospital stay, 20 (19.6%) developed life-threatening events, and 9 (11.7%) died, 4 (5.2%) of an iatrogenic cause (nosocomial infections). Significant differences were found in 20 out of 26 parameters studied ( p b 0.005 for all cases; 95% confidence interval). Eighteen percent of all iatrogenic disease was severe, 61.9% predictable, 54.5% avoidable, and 59% drug-related, 80% of which was due to side effects or adverse reactions. Infection and metabolic and electrolyte disorders were the most frequent effects. Conclusions: It is possible to identify risk factors for iatrogenic events. Chronically ill elderly inpatients are the main target of iatrogenic events.

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Hyponatremia in the emergency department

Cited by 83 publications

References 19 publications

General characteristics of patients with electrolyte imbalance admitted to emergency department

General characteristics of patients with electrolyte imbalance admitted to emergency department

Randomized, Double-Blind Trial of the Effect of Fluid Composition on Electrolyte, Acid–Base, and Fluid Homeostasis in Patients Early After Subarachnoid Hemorrhage

The diseases we cause: Iatrogenic illness in a department of internal medicine

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