Treatment of hyponatremic encephalopathy with a 3% sodium chloride protocol: a case series.
Identifieur interne : 004220 ( Ncbi/Merge ); précédent : 004219; suivant : 004221Treatment of hyponatremic encephalopathy with a 3% sodium chloride protocol: a case series.
Auteurs : Juan Carlos Ayus [Argentine] ; Daniel Caputo [Argentine] ; Fernando Bazerque [Argentine] ; Ricardo Heguilen [Argentine] ; Claudio D. Gonzalez [Argentine] ; Michael L. Moritz [États-Unis]Source :
- American journal of kidney diseases : the official journal of the National Kidney Foundation [ 1523-6838 ] ; 2015.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Femelle, Humains, Hyponatrémie (diagnostic), Hyponatrémie (sang), Hyponatrémie (traitement médicamenteux), Mâle, Oedème cérébral (diagnostic), Oedème cérébral (sang), Oedème cérébral (traitement médicamenteux), Résultat thérapeutique, Solution saline hypertonique (), Solution saline hypertonique (administration et posologie), Sujet âgé, Études de cohortes, Études prospectives.
- MESH :
- administration et posologie : Solution saline hypertonique.
- diagnostic : Hyponatrémie, Oedème cérébral.
- sang : Hyponatrémie, Oedème cérébral.
- traitement médicamenteux : Hyponatrémie, Oedème cérébral.
- Adulte d'âge moyen, Femelle, Humains, Mâle, Résultat thérapeutique, Solution saline hypertonique, Sujet âgé, Études de cohortes, Études prospectives.
English descriptors
- KwdEn :
- Aged, Brain Edema (blood), Brain Edema (diagnosis), Brain Edema (drug therapy), Cohort Studies, Female, Humans, Hyponatremia (blood), Hyponatremia (diagnosis), Hyponatremia (drug therapy), Male, Middle Aged, Prospective Studies, Saline Solution, Hypertonic (administration & dosage), Saline Solution, Hypertonic (chemistry), Treatment Outcome.
- MESH :
- chemical , administration & dosage : Saline Solution, Hypertonic.
- blood : Brain Edema, Hyponatremia.
- chemical , chemistry : Saline Solution, Hypertonic.
- diagnosis : Brain Edema, Hyponatremia.
- drug therapy : Brain Edema, Hyponatremia.
- Aged, Cohort Studies, Female, Humans, Male, Middle Aged, Prospective Studies, Treatment Outcome.
Abstract
3% sodium chloride solution is the accepted treatment for hyponatremic encephalopathy, but evidence-based guidelines for its use are lacking.
DOI: 10.1053/j.ajkd.2014.09.021
PubMed: 25465163
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J. Kidney Dis.</ISOAbbreviation></Journal><ArticleTitle>Treatment of hyponatremic encephalopathy with a 3% sodium chloride protocol: a case series.</ArticleTitle><Pagination><MedlinePgn>435-42</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1053/j.ajkd.2014.09.021</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S0272-6386(14)01346-8</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">3% sodium chloride solution is the accepted treatment for hyponatremic encephalopathy, but evidence-based guidelines for its use are lacking.</AbstractText><AbstractText Label="STUDY DESIGN" NlmCategory="METHODS">A case series.</AbstractText><AbstractText Label="SETTING & PARTICIPANTS" NlmCategory="METHODS">Adult patients presenting to the emergency department of a university hospital with hyponatremic encephalopathy, defined as serum sodium level < 130 mEq/L with neurologic symptoms of increased intracranial pressure without other apparent cause, and treated with a continuous infusion of 500mL of 3% sodium chloride solution over 6 hours through a peripheral vein.</AbstractText><AbstractText Label="PREDICTORS" NlmCategory="METHODS">Hyponatremic encephalopathy defined as serum sodium level < 130 mEq/L with neurologic symptoms of increased intracranial pressure without other apparent cause.</AbstractText><AbstractText Label="OUTCOMES" NlmCategory="RESULTS">Change in serum sodium level within 48 hours, improvement in neurologic symptoms, and clinical evidence of cerebral demyelination, permanent neurologic injury, or death within 6 months' posttreatment follow-up.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">There were 71 episodes of hyponatremic encephalopathy in 64 individuals. Comorbid conditions were present in 86% of individuals. Baseline mean serum sodium level was 114.1±0.8 (SEM) mEq/L and increased to 117.9±1.3, 121.2±1.2, 123.9±1.0, and 128.3±0.8 mEq/L at 3, 12, 24, and 48 hours following the initiation of 3% sodium chloride solution treatment, respectively. There was a marked improvement in central nervous system symptoms within hours of therapy in 69 of 71 (97%) episodes. There were 12 deaths, all of which occurred following the resolution of hyponatremic encephalopathy and were related to comorbid conditions, with 75% of deaths related to sepsis. No patient developed neurologic symptoms consistent with cerebral demyelination at any point during the 6-month follow-up period.</AbstractText><AbstractText Label="LIMITATIONS" NlmCategory="CONCLUSIONS">Lack of a comparison group and follow-up neuroimaging studies. Number of cases is too small to provide definitive assessment of the safety of this protocol.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">3% sodium chloride solution was effective in reversing the symptoms of hyponatremic encephalopathy in the emergency department without producing neurologic injury related to cerebral demyelination on long-term follow-up in this case series.</AbstractText><CopyrightInformation>Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ayus</LastName><ForeName>Juan Carlos</ForeName><Initials>JC</Initials><AffiliationInfo><Affiliation>Renal Consultants of Houston, Houston, TX; Nephrology Division, Hospital Italiano, Buenos Aires, Argentina. Electronic address: carlosayus@yahoo.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Caputo</LastName><ForeName>Daniel</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Nephrology Division, Hospital Alejandro Posadas, Buenos Aires, Argentina.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bazerque</LastName><ForeName>Fernando</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Centro de Rehabilitacion Hirsch, Buenos Aires, Argentina.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Heguilen</LastName><ForeName>Ricardo</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Nephrology Division, Hospital Fernandez, Buenos Aires, Argentina.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gonzalez</LastName><ForeName>Claudio D</ForeName><Initials>CD</Initials><AffiliationInfo><Affiliation>Pharmacology Division, Universidad de Buenos Aires, Buenos Aires, Argentina.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Moritz</LastName><ForeName>Michael L</ForeName><Initials>ML</Initials><AffiliationInfo><Affiliation>Division of Nephrology, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, PA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2014</Year><Month>11</Month><Day>25</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Am J Kidney Dis</MedlineTA><NlmUniqueID>8110075</NlmUniqueID><ISSNLinking>0272-6386</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D012462">Saline Solution, Hypertonic</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Am J Kidney Dis. 2015 Sep;66(3):540</RefSource><PMID Version="1">26300198</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Am J Kidney Dis. 2015 Sep;66(3):540</RefSource><PMID Version="1">26300199</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001929" MajorTopicYN="N">Brain Edema</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007010" MajorTopicYN="N">Hyponatremia</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012462" MajorTopicYN="N">Saline Solution, Hypertonic</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000737" MajorTopicYN="N">chemistry</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">3% sodium chloride</Keyword><Keyword MajorTopicYN="N">Hyponatremia</Keyword><Keyword MajorTopicYN="N">cerebral demyelination</Keyword><Keyword MajorTopicYN="N">electrolyte abnormality</Keyword><Keyword MajorTopicYN="N">hypertonic saline</Keyword><Keyword MajorTopicYN="N">hyponatremic encephalopathy</Keyword><Keyword MajorTopicYN="N">neurologic injury</Keyword><Keyword MajorTopicYN="N">sodium</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2014</Year><Month>05</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2014</Year><Month>09</Month><Day>26</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2014</Year><Month>12</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2014</Year><Month>12</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2015</Year><Month>4</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">25465163</ArticleId><ArticleId IdType="pii">S0272-6386(14)01346-8</ArticleId><ArticleId IdType="doi">10.1053/j.ajkd.2014.09.021</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Argentine</li><li>États-Unis</li></country><region><li>Pennsylvanie</li></region></list><tree><country name="Argentine"><noRegion><name sortKey="Ayus, Juan Carlos" sort="Ayus, Juan Carlos" uniqKey="Ayus J" first="Juan Carlos" last="Ayus">Juan Carlos Ayus</name></noRegion><name sortKey="Bazerque, Fernando" sort="Bazerque, Fernando" uniqKey="Bazerque F" first="Fernando" last="Bazerque">Fernando Bazerque</name><name sortKey="Caputo, Daniel" sort="Caputo, Daniel" uniqKey="Caputo D" first="Daniel" last="Caputo">Daniel Caputo</name><name sortKey="Gonzalez, Claudio D" sort="Gonzalez, Claudio D" uniqKey="Gonzalez C" first="Claudio D" last="Gonzalez">Claudio D. Gonzalez</name><name sortKey="Heguilen, Ricardo" sort="Heguilen, Ricardo" uniqKey="Heguilen R" first="Ricardo" last="Heguilen">Ricardo Heguilen</name></country><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Moritz, Michael L" sort="Moritz, Michael L" uniqKey="Moritz M" first="Michael L" last="Moritz">Michael L. Moritz</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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