Clinical Profile Of Patients With Hyponatremia Admitted In Medical ICU (original) (raw)
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Study of Hyponatremia among Patients Admitted In Icu Of A Tertiary Care Hospital
Introduction:. Hyponatremia, a very common electrolyte abnormality in hospitalized patients and is defined as a serum sodium level <135 mEq/L. Acute hyponatremia poses an immediate danger to the central nervous system. Hyponatremia can eventually lead to seizure and death depending on magnitude and severity of onset [2,3]. Hyponatremia can be classified on the basis of serum osmolality, volume status and urinary sodium into hypertonic, isotonic and hypotonic types. Hyponatremia may also be classified into Hypervolemic, euvolemic and hypovolemic. Materials and Methods:This prospective observational study was done on 344 nos of patients in ICU of Agartala Government Medical College & GBP Hospital.Results: The proportion of patients having hyponatremia among ICU admitted patients in this study was found to be 27.9%. Majority of the patients (62.7%) were in the age group of 41-60 years.Out of the cases of hyponatremia, 61.5% were male and 38.5% were female. In patients of hypernatremia admitted in ICU, there were more number of patients had End Stage Renal disease(ESRD) under Haemo Dialysis, Chronic Liver disease, Cirrhosis of Liver and Septicemia.By assessing the volume status we found that there were more number of hyponatremia among Hypervolemic patients (51%) followed by Hypovolemia (26%) and Euvolemia (22.9%).Conclusion: Hyponatremia is a very common clinical manifestation in patients admitted in icu.When we assess the clinical features among the hyponatremic patients we found that hyponatremia is maximally associated with drowsiness (62.50%) followed by nausea (59.40%), confusion (41.66%), altered sensorium / behaviour (31.25%) and convulsion (5.20%).
Profile of hyponatremia in a tertiary care centre in North India
International Journal of Advances in Medicine, 2016
Hyponatremia defined as serum sodium less than 135 meq/l is the most common electrolyte disorder among hospitalized patients. 1-5 It is associated with mortality and morbidity ranging from 5-50 % depending on severity and acuity of onset. 6 Hyponatremia occurs in a broad spectrum of patients. It affects all age groups and both sexes equally but is most commonly found in elderly persons because of an increase frequency of comorbidities, that can lower serum sodium levels (example cardiac ,hepatic or renal failure). 7-9 Patients in whom the serum sodium concentration is greater than 130 mEq/L are usually asymptomatic, whereas those in whom these values are lower may have symptoms. Symptoms occurring early in hyponatremia are usually anorexia, nausea, vomiting. Some patients may have headache and irritability. As serum sodium levels falls further patients develop neuropsychiatry symptoms. These symptoms range from restlessness, altered consciousness, lethargy, seizures to coma. There ABSTRACT Background: Hyponatremia is the commonest electrolyte imbalance. Hyponatremia is a heterogenous disorder and classified into hypovolemic, euvolemic and hypervolemic types depending on the volume status of the patient. Approach is based on etiology and type of hyponatremia. The aim of the present study was to determine the profile of hyponatremia in adult patients including underlying etiology, type, clinical features and outcome Methods: The study was conducted at BRD medical college Gorakhpur, India between July 2014 to August 2015 after approval by the ethical committee. Consenting patients >18 years of age with hyponatremia (<130meq/l) were included and investigated as per protocol. Based on volume status and urinary sodium patients were classified as euvolemic, hypervolemic and hypovolemic. Results: N = 250, mean age 53.9 years. 56% males, 154(61.6%) patients had euvolemic, 53 (21.2%) hypervolemic and 43(17.2%) hypovolemic hyponatremia. The most common causes for euvolemic, hypervolemic, hypovolemic hyponatremia were CNS infections, CLD and acute gastroenteritis respectively. Neurologic symptoms were more common in severe as compared to mild hyponatremia (69.7% versus 8.1%). Seizures attributable to hyponatremia were seen in 44 patients (17.6%), all with severe hyponatremia. Overall mortality was 14%. Deaths were more frequently seen in patients with severe hyponatremia as compared to patients with mild hyponatremia (25.5% vs. 4.7% P = 0.035). Conclusions: Euvolemic hyponatremia is the most common type seen in hospitalized patients and is associated mainly with intracranial pathologies. Severe hyponatremia is significantly associated with neurological manifestations and higher mortality.
Clinical Profile and Outcome of Patients with Hyponatremia at Tertiary Care Teaching Hospital
Journal of Evolution of Medical and Dental Sciences, 2018
BACKGROUND Hyponatremia is defined as a serum sodium concentration less than 135 mmol/L and is the most common electrolyte disorder encountered in clinical practice. MATERIALS AND METHODS This was a retrospective, descriptive and data analysis study conducted over period of 12 month at a tertiary care centre, to study the clinical profile, aetiology, classification and outcome of hyponatremia. A total 115 consecutive cases who had serum sodium levels of <135 mmol/L were enrolled. The mean and standard deviation and percentage for numerical variables were calculated. Chi square test was used to analyse categorical variables. RESULTS Of a total of 115 patients, 73 (63.47%) were male and 42 (36.52%) were females. There was a predominance of Na + levels of 115-134 mmol/L (mild hyponatremia) 59.13% ['p'< 0.001]. The majority of patients (42.61%) had nausea and/or vomiting ('p'<0.001) and confusion, seizures and coma were associated with moderate to profound hyponatremia ('p' <0.01). The SIADH (37.39%) was the commonest pathophysiological process observed in the present study ['p' <0.0001]. Overall mortality was 9.57%. The patients with Sr. Na + <105 mmol/L had (36.84%) significant mortality compared to >105 mmol/L ['p' <0.002196]. The duration of hospital stay was inversely related to Sr. sodium level. CONCLUSION In present cohort of hyponatremia the SIADH was the commonest aetiology. Confusion, seizures and coma were associated with moderate to profound hyponatremia. The duration of hospital stay was inversely related to serum sodium level with overall mortality of 9.57% which was correlated with severity of hyponatremia.
A prospective study on clinical profile of hyponatremia in ICU hospitalized patients
The incidence of hyponatremia is roughly 12% in ICU hospitalized patients. The precise incidence of hyponatremia varies depending on the conditions leading to and the criteria used to define it. 1 Hyponatremia represents excess of body water relative to body sodium content and is frequently referred to as a serum sodium concentration of less than 135 mEq/L. Hyponatremia is the most common electrolyte disorder, 1 reported to occur in up to 6% of hospitalized patients. 3 Mild hyponatremia plasma sodium 130 -135 mmol / l ) is found in as many as 15 -30% of hospitalized patients or in the institutionalized elderly. 4 Clinically hyponatremia is often unrecognized when it is mild or when it develops slowly. But severe hyponatremia (plasma sodium < 120 mmol / l ), particularly of rapid onset, is associated with substantial morbidity and can be life threatening. 5 Also moderate to severe hyponatremia bears a substantial associated morbidity and mortality. Hyponatremia is associated with varying morbidity. Morbidity varies widely in severity; serious complications can arise from the disturbances itself as well as from the underlying causative conditions. Errors in assessment and management play to a significant extent. Hyponatremia is also an important predictor of mortality in heart failure 7 , cirrhosis 8 and acute pancreatitis. Unfortunately, hyponatremia is more often iatrogenic. Traditional therapies have significant limitations. Newer agents especially those that antagonize arginine vasopressin at V 2 receptor or both the V 1A and V 2 receptors show promise for treating hypervolemic and euvolemic hyponatremia, as they induce desired free water diuresis without inducing sodium excretion. Management of hyponatremia depends upon speed of recognition, its onset, magnitude and severity and associated risk factors especially for neurological complications.
National Journal of Physiology, Pharmacy and Pharmacology, 2017
Background: Hyponatremia, defined as a serum sodium concentration 20 mmol/l, Serum uric acid ≤4 mg/dl, normal renal function (serum creatinine and blood urea) and absence of thyroid or pituitary insufficiency were classified as having Syndrome of inappropriate antidiuresis (SIAD). The sodium estimation was done in the randox automated analyser which measures sodium by ion selective electrode technology. Results: A total of 100 patients with hyponatremia (serum Na+≤130 mEq/L) were included in the study. The mean age of presentation was around 51.5 ± 17.5 years with male to female (M:F) ratio 1.8:1. Severe hyponatremia was detected in 56 patients and the mean sodium level was 118.2 ± 8.1 mEq/L. 43 patients had altered level of consciousness in form of drowsiness, confusion, irrelevant talking or coma, 6 patients had seizure, 38 patients had vomiting, 7 patients had hiccups and 38 hyponatremic patients were asymptomatic. The commonest type of hyponatremia noted in our study was euvolem...
A STUDY ON HYPONATREMIA IN HOSPITALIZED PATIENTS.
Hyponatremia is a common electrolyte abnormality often detected asymptomatically it is also common is hospitalized patients also this study was conducted in Telangana and Andhra Pradesh. in 200 hospitalized patients 60 patients were having hyponatremia where serum sodium is less than 135 M.Eqll /lt. and average age is 62 years. Males patients are 45% and female patient are 55%. Cases of mortality were progressive real failure and sepsis.
2017
Introduction: Hyponatremia is a common electrolyte abnormality in hospitalized patients. It is defined as serum sodium concentration less than 135mEq/L. It occurs due to disruption of sodium and water homeostasis. Clinical presentation varies from asymptomatic patients to ones having seizures and coma. Aims and objective: To delineate the clinical profile and causes of hyponatremia in patients admitted in a medical ward. Material and methods: This study was conducted on 100 patients admitted in medicine ward of tertiary care teaching hospital of northeast India from September 2016 to February 2017. Patients older than 18 years with serum sodium less than 135mEq/L were included in the study. Detailed history, clinical examination and all necessary investigations were done accordingly. P value <0.05 was taken as statistical significance. Results: In the present study 72% were male, and 84% of patients was older than 50 years. Out of all patients 70% were symptomatic, out of which 4...
OBJECTIVE: To determine the frequency, etiology, outcome of hyponatremia at tertiary care hospital PATIENTS AND METHODS: The one year cross sectional survey was conducted from 01 January 2015 to 31 December 2015 at tertiary care hospital Hyderabad. The inclusion criteria of the study were hospitalized patients due to any illness for ≥ 07 days, of ≥12 years of age either gender were be recruited. The serum sodium levels was checked at admission, every day during and then as and when indicated and the serum sodium value <130 mmol/l was labeled as low or hyponatremia while the value <125 mmol /l was labeled as severe hyponatremia. The frequency and percentages (%) was computed while the mean ± SD for also calculated for numerical variables. RESULTS: Total 87 hyponatremic individuals were rationalized during one year study period. The mean ±SD for age and serum sodium level for whole population was 58.97±8.64 and 127.31±3.52 respectively. The treatment was initialized. The symptomatic patients were managed by IV hypertonic saline with rate and dose calculation followed by oral salt supplementation. Ten patients (19%) hyponatremic subjects expired during hospitalization whereas no any case of central pontine myelinolysis was detected in our study population. The hyponatremia was identified in 52 (59.7%) with male gender predominance 32 (61.5%). The common etiological factors detected were GI fluid loss 12 (13.8%), CVA 10 (11.5%), lungs abscess 11 (12.6%) and renal failure 10 (11.5%) respectively. The mild, moderate and severe hyponatremia was detected in 17 (32.7%), 24 (46.2%) and 11 (21.2%). CONCLUSION: Hyponatremia is fairly common in patients admitted in emergency wards
Etiology, Clinical Features and Outcomes of Treatment of Hyponatremia -A Prospective Study
https://www.ijrrjournal.com/IJRR\_Vol.9\_Issue.3\_March2022/IJRR-Abstract051.html, 2022
Hyponatremia is a common problem encountered in patients presenting with nonspecific symptoms. Symptomatology depends more on the rate of development of the electrolyte abnormality than on its severity. Data regarding the incidence of hyponatremia in hospitalized patients in our country is limited. This prospective, descriptive study was conducted at Ramakrishna care hospital Raipur from September 2016-November 2017.100 cases were taken by random sampling method to know the common clinical features etiology and treatment outcome of hospitalized patients and study the morbidity and mortality in such patients. hyponatremia presented with various clinical symptoms out of which nausea was most common followed by vomiting ,altered sensorium and seizure. Physician need to be aware about the common occurrence of hyponatremia and early identification to prevent serious complication like seizures. Over all most common cause of hyponatremia in all 3 group was diuretics and salt restriction (53%). most of hyponatremic patients were hypertensive and number of cases increased from mild to severe hyponatremia secondary to diuretic and salt restriction it was statistically highly significant i.e. 54% (p<0.0001).
CLINICO ETIOLOGICAL PROFILE OF HYPONATREMIA IN IMCU OF KANNIYAKUMARI GOVERNMENT MEDICAL COLLEGE
Background : Sodium is the dominant extracellular cation and its homeostasis is vital to the normal physiologic function of cells. Hyponatremia is defined as a serum level of <135 mmol/L. This study is to evaluate aetiological factors, clinical features of patients with hyponatremia in IMCU (Intensive Medical Care Unit). Methods: An observational study was conducted in 100 patients admitted in Kanniyakumari Govt. Medical College from Jan 2016 to Dec 2016 who had serum Sodium <130mmol/L. History, examination and relevant details were taken. Results:In the present study, the mean age was 68 years. 37% were asymptomatic. The major clinical presentation among those symptomatic was altered sensorium accounting for 45%. The commonest cause was SIADH(Syndrome of Inappropriate AntiDiuretic Hormone secretion) followed by extra-renal causes. The mortality was 5%. Conclusions: Hyponatremia is one of the common causes of altered consciousness and seizures especially in elderly patients. It is very important to classify the hyponatremia and find out the correct etiology. Treatment of hyponatremia is highly rewarding and it should be done in a more scientific way. The common causes and the management protocol should be available in every IMCU.3