在患有低血症住院的患者中透性脱化综合征
Thomas E MacMillan1,2, Saeha Shin3, Joel Topf4
1Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON.
NEJM evidence
|February 6, 2024
概括
透性脱髓化综合征 (ODS) 是低血治疗的罕见并发症. 这项研究发现,ODS仅在0.05%的低血症住院患者中发生,即使水平得到了快速纠正.
科学领域:
- 神经学 神经学
- 腎臟病學 (nephrology) 是一種醫學.
- 内部医学 内部医学
背景情况:
- 透性脱髓化综合征 (ODS) 是一种与低血相关的严重神经复杂症.
- 了解低血患者的ODS发病率对于临床管理至关重要.
研究的目的:
- 确定在住院低血症患者的大型,当代的多中心队列中,患有ODS的患者比例.
- 为了研究血清的快速校正和ODS发展之间的关系.
主要方法:
- 一项涉及加拿大多伦多五家学术医院的多中心队列研究 (2010年4月 - 2020年12月).
- 纳入标准:接受治疗的成年患者患有低血量 (血清含量≤135 mmol/L).
- 收集了关于血清水平,校正率和ODS发展的数据.
主要成果:
- 该队列包括22,858例因低血症住院治疗.
- 在17.7%的入院患者中,发生了快速的血清度修正.
- 只有12名患者 (0.05%) 患有ODS;其中58%的人没有经历快速纠正.
结论:
- ODS是一种罕见的低血症并发症,在这个队列中发生的病例为0.05%.
- 快速的血清正,虽然很常见,但并不普遍与ODS发展有关.
- 需要对更大的ODS队伍进行进一步的研究,以阐明因果因素.
更多相关视频
相关概念视频
Disorder of Water Balance
399
Water balance disorders are medical conditions that occur when there is a deviation from the body's water volume or osmolarity, disrupting normal homeostasis and leading todehydration, hypotonic hydration, hyperhydration, edema, or water intoxication.
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
399
Regulation of Water Intake
506
Osmolality refers to the number of solute particles per kilogram of solvent in a solution. Plasma osmolality specifically indicates the total number of solute particles per kilogram of water in blood plasma. This value reflects the body's hydration status and is tightly regulated through mechanisms controlling water intake and output. While water consumption is a conscious decision, the body has intrinsic regulatory systems to maintain fluid balance. Dehydration, a state of water deficit...
506
Tonicity in Animals
3.1K
Tonicity describes the amount of solute in a solution. The measure of the tonicity of a solution, or the total amount of solutes dissolved in a specific amount of solution, is called its osmolarity. Three terms—hypotonic, isotonic, and hypertonic—are used to relate the osmolarity of a cell to the osmolarity of the extracellular fluid that contains the cells. In a hypotonic solution, such as tap water, the extracellular fluid has a lower concentration of solutes than the fluid inside...
3.1K
Antihypertensive Drugs: Potassium-Sparing Diuretics
560
Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
560
Formation of Dilute Urine
1.6K
The formation of dilute urine is a critical renal adaptation that maintains fluid balance, particularly during periods of high fluid intake. This process primarily involves the juxtamedullary nephrons. By adjusting the permeability of water and ions in response to physiological conditions, the kidneys can either conserve or excrete water, resulting in concentrated or dilute urine.
Filtrate Osmolarity in the PCT
Initially, as the filtrate passes through the proximal convoluted tubule (PCT), its...
Filtrate Osmolarity in the PCT
Initially, as the filtrate passes through the proximal convoluted tubule (PCT), its...
1.6K
Formation of Concentrated Urine
1.7K
There is a gradient of solutes in the interstitial fluid from the renal cortex through the medulla, known as the medullary osmotic gradient. The juxtamedullary nephrons establish and maintain this gradient using countercurrent mechanisms with loops extending deep into the medulla. These nephrons also use countercurrent mechanisms to regulate urine volume and concentration. The interaction between the descending and ascending limbs of the nephron loop creates an osmotic gradient through...
1.7K


