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Related Concept Videos

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Updated: Oct 9, 2025

Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
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Hypernatremia in the intensive care unit.

Raja Chand1, Ranjeeta Chand, David S Goldfarb

  • 1Nephrology Division, New York University Langone Health, NYU Grossman School of Medicine, and Nephrology Section, NY Harbor VA Healthcare System, New York, New York, USA.

Current Opinion in Nephrology and Hypertension
|December 23, 2021
PubMed
Summary
This summary is machine-generated.

Hypernatremia, a common electrolyte disorder in critically ill patients, is linked to increased mortality. Correcting hypernatremia with electrolyte-free water is recommended to improve outcomes and reduce length of stay.

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Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Electrolyte Disorders

Background:

  • Hypernatremia affects up to 27% of intensive care unit (ICU) patients.
  • A clinical debate exists regarding the correction of hypernatremia due to concerns about extracellular fluid volume expansion.
  • Intensivists and nephrologists hold differing views on the risks and benefits of hypernatremia correction.

Purpose of the Study:

  • To review the controversy surrounding the management of hypernatremia in critically ill patients.
  • To evaluate the evidence for and against correcting hypernatremia.
  • To discuss the implications of hypernatremia persistence versus correction.

Main Methods:

  • Review of existing literature and clinical associations.
  • Discussion of total body water distribution principles.
  • Analysis of the impact of hypernatremia on patient outcomes.

Main Results:

  • No randomized clinical trials (RCTs) specifically guide electrolyte-free fluid administration in hypernatremia.
  • Existing literature associates hypernatremia of any severity with increased mortality and length of stay (LOS).
  • These associations support the correction of hypernatremia.

Conclusions:

  • Persistence of hypernatremia is linked to higher mortality, longer LOS, and increased post-discharge mortality.
  • Appropriate use of electrolyte-free water intake is expected to prevent adverse outcomes.
  • Correction of hypernatremia is supported by current evidence and physiological understanding.