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Paper Information

Journal:   JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE   2007 , Volume 29 , Number 57; Page(s) 24 To 30.
 
Paper: 

SODIUM DISTURBANCES AND ITS RELATION WITH MORTALITY AND MORBIDITY IN HEAD TRAUMA PATIENTS ADMITTED TO GENERAL ICU AT ZAHEDAN KHATAM-AL-ANBIA HOSPITAL FROM MAY 2003 TO SEPTEMBER 2004

 
 
Author(s):  AMINI SH., HEYDARI Z.
 
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Abstract: 

Background: Serum sodium disturbances frequently occur in head trauma patients that might exacerbate their neurological disturbances. The disturbance may be manifested as hypematremia or hyponatremia. Hypernatremia usually occurs in the form of syndrome of diabetes insipidus, whereas hyponatremia develops as a syndrome of inappropriate secretion of ant diuretics hormone (SIADH) or cerebral salt wasting (CSWS).
Materials and methods: In a prospective descriptive survey, we studied 150 patients with isolated head trauma admitted to the intensive care unit at Khatamal- Anbia Hospital from April 2003 to September 2004. For all the patients the following parameters were recorded daily: sex, age, blood pressure, Na, K, BUN, Cr, BS, Ca. In the case of any sodium disturbances, further lab data such as urine sodium, osmoloarity, SG, urine output plasma and urine uric acid were requested to determine the etiology. All data were analyzed by SPSS software, X2, and exact Fischer test.
Results: Of 150 patients with head trauma sodium disturbances were detcted in 34 patients: Hypernatremia in 22 and hyponatremia in 12 patients. The patients with hypernatremia in 22 and hyponatremia in 12 patients. The patients with hypernatremia developed 01. The mean of GCS in this group was 5.59 and 18 (81.8%) patients died. The mortality rate was higher in patients with more severe hypematremia with lower GCS. In patients with hyponatremia, 9 (75%) of them developed SIADH and 3 (25%) developed CSW. The mean of GCS in this group was 7.25 and 3 (25%) of them died. There was no statistically significant relationship between hyponatremia and mortality (p=0.7) but there was statistically significant relationship between hypematremia and mortality (P<0.001).
Discussion: disturbances of plasma sodium concentration should be seriously considered in patients with head trauma to allow timely and appropriate therapeutic intervention that may exacerbate the patients condition and eventully lead to death.

 
Keyword(s): HYPONATREMIA, HYPERNATREMIA, MORTALITY ICU
 
References: 
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