Impact of hyponatraemia in critically ill patients

Context:Hyponatremia is a common electrolyte disturbance in critically ill hence understanding its implications is important.Aims:This study was carried out to ascertain frequency, predisposing conditions and outcome in critically ill patients with hyponatremia on intensive care unit (ICU) admission.Settings and Design:This was an observational, prospective study of a series of ICU patients during a 12-month period.Materials and Methods:The patients were divided into two groups: Hyponatremic (serum sodium < 135 mmol/L) and Eunatremic groups (135-145 mmol/L). Clinical examination included volume status and drug history, biochemistries, clinical diagnosis and cause of hyponatremia.Statistical Analysis Used:Fisher's exact test, unpaired t-tests Wilcoxon ranksum tests, profile-likelihood method, log-rank test and Kaplan—Meier curves were used. P < 0.05 were considered to be statistically significant.Results:In the hyponatremic group, the frequency of hyponatremia on ICU admission was 34.3%, most were euvolumic, 58.96%. Females comprised of 36.5%. The mean age was 60.4 ± 17.2. The Syndrome of inappropriate Antidiuretic Hormone (SIADH) criteria was met in ninety-one patients (36.25%), peumonia being the leading cause of SIADH. Patients with severe sepsis, elective surgery patients, renal failure and heart failure, cirrhosis of liver and subarachnoid hemorrhage were other more likely etiologic causes (P < 0.05). The hyponatremic group spent a longer time in the ICU (P = 0.02), had longer mechanical ventilator days (P < 0.05) and had an increased mortality rate (P = 0.01).Conclusions:Hyponatremia present on admission to the ICU is independent risk factors for poor prognosis.

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“…also found an increased mortality and ICU length of stay and increased ventilator days among hyponatremic patients admitted to ICU. [ 14 ]…”

Section: Discussionmentioning

confidence: 99%

Hyponatremia in critically ill patients

Padhi

Panda

Jagati

et al. 2014

Indian Journal of Critical Care Medicine

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“…In another study, Shakhe et al ( 2013) found an increased requirement of ventilator days along with increase length of ICU stay among the patients who had hyponatremia during ICU admission 12 . Pillai et al (2018) in a tertiary care hospital found significant increase in duration of stay in ICU in patients with hyponatremia (p=0.003) 3 .…”

Section: Introductionmentioning

confidence: 97%

Frequency of hyponatremia and its outcome in critically ill patients

Uddin¹,

Ahsan

Faria³

et al. 2021

Bangladesh Crit Care J

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Background: Disorders of sodium (Na+) and water homeostasis are common in hospitalized patients particularly in Intensive Care Unit (ICU). Irrespective of the etiology it is associated with worse outcome and increase length of ICU stay. Objectives: Objective of the current study is to determine the frequency of hyponatremia and its association with the outcome of critically ill Patients admitted in the Department of Critical Care Medicine, BIRDEM General Hospital. Methods: This prospective observational cross-sectional study was taken place in department of Critical Care Medicine for a period of one year from 1st July, 2017 to 30th June, 2018. Consecutive 296 critically ill patients during this time period were included in this study according to selection criteria. Data were collected in preformed data collection sheet and analyzed by the statistical packages for social science (SPSS) software (version 20.0) Results: In this study total 296 patients after fulfilling the inclusion criteria were selected as study participants. The mean age of the patients was 62.21±12.974 years and there were61.5% male and 38.5% female. Among male patients 39.6% had hyponatremia and among female patients 44.9% (p=0.09). Overall frequency of hyponatremia was 41.2%. Majority of the patients presented with respiratory distress (61.5%), altered level of consciousness (33.4%), hypotension (30%) and fever (18.9%). DM (90.5%), HTN (75.5%) and CKD (50.5%) were the most frequent comorbidities present among the participants. Most of the hyponatremic patients were euvolemic (50.00%). Mean APACHE ll score among hyponatremic patients was significantly high (p= 0.001) moreover, hyponatremic patients required more mechanical support (p= 0.001).Duration of ICU stay was not related to severity of baseline hyponatremia during admission (p= 0.08)). In addition, outcome of the patients also depends on the overall incidence of hyponatremia and degree of hyponatremia (p<0.05 in both cases). Conclusion: More than one-third of critically ill patients had hyponatremia and it was related to poor outcome of the critically ill patients. Bangladesh Crit Care J September 2021; 9 (2): 68-73

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Impact of hyponatraemia in critically ill patients

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Hyponatremia in critically ill patients

Hyponatremia in critically ill patients

Frequency of hyponatremia and its outcome in critically ill patients

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