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Dysnatremia in the ICU
Milap Pokaharel1, Clay A Block
1Section of Nephrology and Hypertension, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Current Opinion in Critical Care
|October 27, 2011
Summary
Dysnatremias, or disorders of sodium concentration, are common in critically ill patients and often acquired in hospitals. Simplified treatment strategies are emerging for better diagnosis and management of these complex conditions.
Area of Science:
- Critical Care Medicine
- Nephrology
- Internal Medicine
Background:
- Dysnatremias (disorders of sodium concentration) are prevalent in critically ill patients, increasing mortality risk.
- The underlying physiology of dysnatremias is complex, posing diagnostic and management challenges.
- Hospital acquisition or exacerbation of dysnatremia is frequently observed.
Purpose of the Study:
- To review current literature on the pathophysiology, epidemiology, diagnosis, and management of dysnatremias.
- To discuss the refined role of arginine vasopressin in understanding and diagnosing dysnatremia.
- To highlight emerging consensus treatment strategies for these disorders.
Main Methods:
- Literature review of current research on dysnatremias.
- Analysis of recent epidemiologic studies.
- Synthesis of established and evolving diagnostic criteria and management guidelines.
Main Results:
- Arginine vasopressin's role in osmolality regulation is increasingly understood, aiding dysnatremia diagnosis.
- Epidemiologic data confirm adverse outcomes associated with dysnatremia and its frequent hospital acquisition.
- Simplified, consensus-based treatment approaches for dysnatremia have been proposed.
Conclusions:
- Dysnatremia is a common, often hospital-acquired condition in critically ill patients.
- Simplified treatment regimens are suggested, emphasizing early recognition and intervention.
- Future research should focus on dysnatremia's contribution to adverse outcomes and novel therapeutic strategies.
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