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Clin Endocrinol (Oxf) 2019 Apr 20. Epub 2019 Apr 20.

Departments of Endocrinology, Diabetology and Metabolism University Hospital Basel, Switzerland.

Copeptin is secreted in an equimolar amount to arginine vasopressin (AVP) but can easily be measured in plasma or serum with a sandwich immunoassay. The main stimuli for copeptin are similar to AVP, i.e. Read More

Ann Burns Fire Disasters 2018 Dec;31(4):271-277

Vietnam National Institute of Burns, Hanoi, Vietnam.

A descriptive study was conducted on 135 adult severe burn patients treated at the Burn ICU, National Institute of Burns from 1/2017 to 12/2017. Hypernatremia was defined as increased plasma sodium ≥ 146 mmol/l. It was recorded in 24. Read More

Ann Hum Genet 2019 Apr 12. Epub 2019 Apr 12.

The Morris Kahn Laboratory of Human Genetics, National Institute for Biotechnology in the Negev and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Four affected individuals of consanguineous kindred presented at infancy with an apparently autosomal recessive syndrome of polyuria and hypokalemic metabolic alkalosis, following maternal polyhydramnios and premature delivery, culminating in severe failure to thrive. Hypercalciuria, nephrocalcinosis, and hyperaldosteronism were further apparent as well as an unusual finding of intermittent hypernatremia. Additionally, all patients demonstrated variable micrognathia with upper respiratory airway abnormalities. Read More

Am J Hypertens 2019 Apr 12. Epub 2019 Apr 12.

Division of Geriatrics, University of Utah and VA Salt Lake City Geriatric Research, Education and Clinical Center, Salt Lake City, UT.

Background: High dietary sodium intake may induce a small, yet physiologically relevant rise in serum sodium concentration, which associates with increased systolic blood pressure (SBP). Cellular data suggest that this association is mediated by increased endothelial cell stiffness. We hypothesized that higher serum sodium levels were associated with greater arterial stiffness in participants in the Systolic Blood Pressure Intervention Trial (SPRINT). Read More

Clin Kidney J 2019 Apr 13;12(2):180-187. Epub 2018 Apr 13.

Department of Pediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.

Background: Inherited nephrogenic diabetes insipidus (NDI) is a rare disorder characterized by impaired urinary concentrating ability. Little clinical data on long-term outcome exists.

Method: This was a single-centre retrospective medical record review of patients with a diagnosis of NDI followed between 1985 and 2017. Read More

Am J Physiol Renal Physiol 2019 Apr 10. Epub 2019 Apr 10.

school of pharmacy, China medical university, Taichung, Taiwan, Taiwan.

Liddle syndrome is an inherited form of human hypertension caused by increasing ENaC (epithelial sodium channel) expression. Increased Na retention through ENaC with subsequent volume expansion causes hypertension. In addition to ENaC, NKCC (Na-K-Cl cotransporter) and NCC (Na-Cl symporter) are responsible for Na reabsorption in the kidneys. Read More

Clin J Am Soc Nephrol 2019 Apr 4. Epub 2019 Apr 4.

Division of Nephrology, Department of Medicine, and

Background And Objectives: Hypernatremia is common in hospitalized, critically ill patients. Although there are no clear guidelines on sodium correction rate for hypernatremia, some studies suggest a reduction rate not to exceed 0.5 mmol/L per hour. Read More

Cureus 2019 Jan 21;11(1):e3926. Epub 2019 Jan 21.

Internal Medicine, Dow University of Health Sciences, Karachi, USA.

Introduction Electrolyte disturbances are commonly found in acute stroke settings. Hypernatremia, hyponatremia and hypokalemia are the commonest types of electrolyte disturbances. Data on electrolyte changes in neurological disorders like stroke is insufficient in Asia. Read More

J Perinatol 2019 Apr 1. Epub 2019 Apr 1.

Pediatrix Medical Group, San Antonio, TX, USA.

Objective: The objective of this study is to discern patterns of serum sodium in a broad cohort of extremely low birth weight (ELBW) infants and associate those patterns with hospital outcomes.

Study Design: Retrospective cohort study of ELBW infants from 323 neonatal intensive care units (NICUs) discharged from 2004 to 2014. We included patients who survived at least 7 days and had daily sodium levels available, and categorized infants by their minimum and maximum sodium levels. Read More

Int J Surg Case Rep 2019 Mar 19;57:71-73. Epub 2019 Mar 19.

Department of Internal Medicine, Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, MI, USA.

Introduction: Nephrogenic diabetes insipidus occurs in patients on chronic lithium treatment even after lithium discontinuation. Patients affected by this disorder are highly vulnerable to hypernatremia when they cannot respond to their thirst mechanism. We report a rare case of hypernatremia due to undiagnosed nephrogenic diabetes insipidus post esophagectomy in a patient with remote history of lithium use. Read More

Am J Physiol Renal Physiol 2019 Mar 25. Epub 2019 Mar 25.

Division of Nephrology & Hypertension, Department of Medicine, Oregon Health & Science University and the VA Portland Health Care System, United States.

Little is known about the population genetics of water balance. A recent meta-GWAS on plasma sodium concentration identified novel loci of high biological plausibility, yet heritability was never convincingly shown in European ancestry. The present analysis linked the Vietnam Era Twin Registry with the Department of Veterans Affairs VistA database. Read More

Eur J Med Genet 2019 Mar 17. Epub 2019 Mar 17.

Clinical Genetics, UFCSPA and Santa Casa de Misericórdia de Porto Alegre (SCMPA), RS, Brazil; Graduate Program in Pathology, UFCSPA, RS, Brazil. Electronic address:

Holoprosencephaly is the most common brain malformation in humans and it is a complex genetic disorder. We report on a patient with holoprosencephaly caused by a rare ZIC2 mutation presenting a bifid nose associated with a nasal fistula and an epidermal cyst, besides hypernatremia. The patient was a 1 year and 4 months old girl that developed an important neuropsychomotor delay. Read More

Public Health Nutr 2019 Mar 21:1-11. Epub 2019 Mar 21.

2Department of Cardiology,The First Hospital of China Medical University,155 Nanjing Bei Street, Shenyang110001,Liaoning,People's Republic of China.

Objective: The present epidemiological study aimed to evaluate the association of serum electrolyte levels with hypertension in a population with a high-salt diet.

Design: Secondary analysis of epidemiology data from the Northeast China Rural Cardiovascular Health Study conducted in 2012-2013. Blood pressure and hypertension status were analysed for association with serum sodium, potassium, chloride, total calcium, phosphate and magnesium levels using regression models. Read More

Nephron 2019 Mar 19:1-11. Epub 2019 Mar 19.

Division of Nephrology, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia, USA,

Background: Experimental evidence suggests that hyperosmolality may be a causative factor in the development of both salt-sensitive hypertension and chronic kidney disease (CKD). There are no population-wide studies in young persons to assess the relationships among these factors.

Objective: To determine the association of serum osmolality and serum sodium with high systolic blood pressure (SBP) and decreased estimated glomerular filtration rate (eGFR) among a nationally representative population of adolescents. Read More

Pediatr Emerg Care 2019 Mar 11. Epub 2019 Mar 11.

From the Department of Pediatrics.

Septo-optic dysplasia is a rare congenital heterogeneous malformation comprising at least 2 components of the triad: optic nerve hypoplasia, pituitary hormone abnormalities, and midline brain defects. We report a 2-month-old girl who presented with hypernatremia, constipation, and increased sleepiness with mother's recent appreciation of abnormal eye movements. We discuss the diagnosis and management of this patient who avoided significant morbidity by prompt diagnosis based initially on clinical suspicion. Read More

Stroke 2019 Apr;50(4):828-836

From the Neurological Intensive Care Unit, Department of Neurology (V.R., B.-A.I., A.W., M.G., A.J.S., M.K., A.L., A.A., S.S.A., B.P., R.B., R.H.), Medical University of Innsbruck, Austria.

Background and Purpose- Global cerebral edema occurs in up to 57% of patients with subarachnoid hemorrhage (SAH) and is associated with prolonged hospital stay and poor outcome. Recently, admission brain edema was successfully graded using a simplified computed tomography-based semiquantitative score (subarachnoid hemorrhage early brain edema score [SEBES]). Longitudinal evaluation of the SEBES grade may discriminate patients with rapid and delayed edema resolution after SAH. Read More

Curr Opin Crit Care 2019 Apr;25(2):132-137

Department of Anesthesiology and Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France.

Purpose Of Review: To describe the pathophysiology and pharmacotherapy of dysnatremia in neurocritical care patients.

Recent Findings: Sodium disorders may affect approximately half of the neurocritical care patients and are associated with worse neurological outcome and increased risk of death. Pharmacotherapy of sodium disorders in neurocritical care patients may be challenging and is guided by a careful investigation of water and sodium balance. Read More

Rev Endocr Metab Disord 2019 Mar 8. Epub 2019 Mar 8.

Medicover GmbH, Berlin, Germany.

Cerebral edema and elevated intracranial pressure (ICP) are common complications of acute brain injury. Hypertonic solutions are routinely used in acute brain injury as effective osmotic agents to lower ICP by increasing the extracellular fluid tonicity. Acute kidney injury in a patient with traumatic brain injury and elevated ICP requiring renal replacement therapy represents a significant therapeutic challenge due to an increased risk of cerebral edema associated with intermittent conventional hemodialysis. Read More

Diabetes Ther 2019 Apr 6;10(2):765-771. Epub 2019 Mar 6.

Division of Critical Care, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.

Introduction: We present a case wherein diabetic ketoacidosis (DKA) was treated with a large amount of sodium bicarbonate and potassium chloride, resulting in the development of osmotic demyelination syndrome (ODS).

Case Presentation: Our patient was a 29-year-old male with a history of post-surgical repair for ventricular septal defect. Upon arrival, the patient's Glasgow Coma Scale (GCS) score was E2M4V3. Read More

Arthritis Rheumatol 2019 Feb 28. Epub 2019 Feb 28.

Dokuz Eylul University School of Medicine, Department of Rheumatology, Izmir, Turkey.

A 25-year-old, previously healthy female presented with a 3 months history of new-onset headache, polyuria and polydipsia. There was no infection, trauma, or drug intake prior symptoms. Physical examination was unremarkable; laboratory tests were consistent with increased inflammation markers along with hypernatremia, high serum osmolality, and low urine osmolality. Read More

MedEdPORTAL 2018 Mar 16;14:10694. Epub 2018 Mar 16.

Professor, Department of Pediatrics, Robert Larner, MD, College of Medicine at the University of Vermont.

Introduction: Volume depletion is a common problem in pediatrics. Interns need to be able to recognize critical illness such as hypovolemic shock, obtain access, and manage complications. This simulation case involves a child with hypovolemic shock who requires intraosseous (IO) needle placement. Read More

Case Rep Pediatr 2019 17;2019:7381597. Epub 2019 Jan 17.

Klinik für Kinder-und Jugendmedizin, Evangelisches Krankenhaus Lippstadt, Wiedenbrückerstr. 33, 59555 Lippstadt, Germany.

We present a case of a nearly 3-year-old girl who was admitted to hospital due to severe hypernatremia (196 mmol/l). Her medical history included central hypothyreosis and growth hormone deficiency. Rehydration and normalization of sodium was achieved according to guidelines. Read More

Clin Interv Aging 2019 30;14:225-229. Epub 2019 Jan 30.

Department of Nephrology, University Côte d'Azur, University Hospital of Nice, Nice, France.

Purpose: Water balance disorders are associated with a high risk of death in elderly patients. The role of osmotic stress intensity and its direction toward hypo- or hypernatremia is a matter of controversy regarding patients' survival. The aims of this study were, first, to measure the frequency of cellular hydration disorders in patients over 75 years old hospitalized in nephrology department for reversible acute renal failure, and second, to compare the impact of hyperhydration and hypohydration on the risk of death at 6 months. Read More

Crit Care Clin 2019 Apr 28;35(2):187-200. Epub 2019 Jan 28.

Intensive Care Unit, Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia.

Diabetes insipidus and the syndrome of inappropriate antidiuretic hormone secretion lie at opposite ends of the spectrum of disordered renal handling of water. Whereas renal retention of water insidiously causes hypotonic hyponatremia in syndrome of inappropriate antidiuretic hormone secretion, diabetes insipidus may lead to free water loss, hypernatremia, and volume depletion. Hypernatremia and hyponatremia are associated with worse outcomes and longer intensive care stays. Read More

Scand J Clin Lab Invest 2018 Nov - Dec;78(7-8):632-638

a School of Medicine and Dentistry , University of Aberdeen , Aberdeen , UK.

Our aim was to explore biological variation of serum sodium levels as a method of quantifying health risk in older adults. We investigated whether dynamic changes in serum sodium levels could provide additional prognostic information to standard predictors of mortality in older people. Analysis of routinely collected clinical datasets containing information on demographics, hospitalisation, biochemistry, haematology and physical function for Dundee in-patient rehabilitation services, between 1999 and 2011. Read More

Transplantation 2019 Feb 4. Epub 2019 Feb 4.

Division of Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI, USA.

Background: Status 1A patients are prioritized over liver disease patients regardless of model for end-stage liver disease (MELD) score. We aimed to identify groups with high waitlist mortality in Status 1A and MELD≥40 patients to determine who would most benefit from transplantation.

Methods: Data on patients listed as Status 1A (n=4447) and MELD≥40 (n=3663) over 15 years (2002 to 2017) obtained from UNOS/OPTN registry. Read More

Clin J Am Soc Nephrol 2019 Mar 6;14(3):432-434. Epub 2019 Feb 6.

Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic School of Medicine, Rochester, Minnesota

Behav Brain Res 2019 May 25;363:118-125. Epub 2019 Jan 25.

Departamento de Neurobiología Celular y Molecular, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Campus Juriquilla, Boulevard Juriquilla 3001, Juriquilla, Querétaro, CP76230, Mexico. Electronic address:

Anorexia by osmotic dehydration is an adaptive response to hypernatremia and hyperosmolaemia induced by ingestion of a hypertonic solution. Dehydration-induced anorexia (DIA) reproduces weight loss and avoidance of food, despite its availability. By using this model, we previously showed increased reactive astrocyte density in the rat dorsal hippocampus, suggesting a pro-inflammatory environment where microglia may play an important role. Read More

Clin Toxicol (Phila) 2019 Jan 28:1-9. Epub 2019 Jan 28.

a National Poisons Centre , University of Otago , Dunedin , New Zealand.

Introduction: Sodium hypochlorite is used as a bleaching and disinfecting agent and is commonly found in household bleach.

Objective: The objective is to review critically the epidemiology, mechanisms of toxicity, clinical features, diagnosis, and management of hypochlorite poisoning.

Methods: PubMed was searched from January 1950 to June 2018 using the terms "Hypochlorite", "Sodium Hypochlorite", "Sodium Oxychloride", "Hypochlorous Acid", "Bleach", "Chlorine Bleach", in combination with the keywords "poisoning", "poison", "toxicity", "ingestion", "adverse effects", "overdose", and "intoxication". Read More

Bratisl Lek Listy 2019;120(1):52-57

Background: Hypernatremia supports the movement of water from the intracellular to the intercellular space. This shift leads to cells shrinkage and disruption of intracellular processes, representing risk factors of morbidity and mortality in clinical circumstances. On the other hand, hypernatremia triggers protective mechanisms that counteract damage of cells. Read More

Cureus 2018 Nov 19;10(11):e3616. Epub 2018 Nov 19.

Internal Medicine, West Virginia School of Osteopathic Medicine, Lewisburg, USA.

The incidence of serotonin syndrome in the United States is rising yearly. Providers should be aware of the useful diagnostic criteria and have a low threshold for utilizing such criteria to prevent increased morbidity and mortality. In this case, a 64-year-old female with a complex past medical history presented to the emergency department with an altered mental status after being found poorly responsive by her husband. Read More

Mil Med Res 2019 01 25;6(1). Epub 2019 Jan 25.

Division of Kinesiology, Wayne State University, Detroit, MI, USA.

Background: It remains unclear if ad libitum water drinking, as a hydration strategy, prevents exercise-associated hyponatremia (EAH) during prolonged exercise. The aim of this study was to determine the incidence of EAH within the broader context of fluid regulation among soldiers performing a 40-km route-march ingesting water ad libitum.

Methods: Twenty-eight healthy male soldiers participated in this observational trial. Read More

J Clin Anesth 2019 08 16;55:144-145. Epub 2019 Jan 16.

Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan.

Clin Case Rep 2019 Jan 11;7(1):51-53. Epub 2018 Nov 11.

Department of Pediatrics, School of Medicine The university of Jordan Amman Jordan.

A three-day-old newborn girl presented with decreased feeding and dehydration. She was sick and in shock. She had renal impairment and hypernatremia. Read More

Pan Afr Med J 2018 6;30:250. Epub 2018 Aug 6.

Department of Paediatrics, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.

We describe a three-year-old boy who had a growth and psychomotor retardation associated with inappropriate lack of thirst and vasopressin secretion in the presence of chronic plasma hyperosmolarity. Computed brain tomography revealed bilateral supratentorial sub-ependymal and cortical calcifications. Dissociation in the plasma vasopressin response to osmotic change was demonstrated in this patient. Read More

Clin Endocrinol (Oxf) 2019 Apr 25;90(4):630-636. Epub 2019 Jan 25.

Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.

Objective: Hyponatraemia in hospitalized patients is common and associated with increased mortality. International guidelines give conflicting advice regarding the role of urea in the treatment of SIADH. We hypothesized that urea is a safe, effective treatment for fluid restriction-refractory hyponatraemia. Read More

Neuron 2019 Jan;101(1):3-5

Department of Pharmacology, University of Virginia, Charlottesville, VA 22908, USA. Electronic address:

Hypernatremia is known to elicit a rise in sympathetic tone and blood pressure. In this issue of Neuron, Nomura et al. (2018) now show that this is mediated via the organum vasculosum laminae terminalis (OVLT). Read More

Endocrinol Diabetes Metab Case Rep 2018 28;2018. Epub 2018 Dec 28.

Division of Rheumatology, Department of Pediatrics.

IgG4-related hypophysitis is an important diagnostic consideration in patients with a pituitary mass or pituitary dysfunction and can initially present with headaches, visual field deficits and/or endocrine dysfunction. Isolated IgG4-related pituitary disease is rare, with most cases of IgG4-related disease involving additional organ systems. We report the case of a teenage female patient with isolated IgG4-related hypophysitis, diagnosed after initially presenting with headaches. Read More

Am J Emerg Med 2019 Mar 14;37(3):499-501. Epub 2018 Dec 14.

Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine.

Introduction: Dysnatremia is one of the most commonly encountered electrolyte disorders in the emergency department (ED). Few studies have reported the prevalence of dysnatremia in elderly patients without chronic kidney disease (CKD). We investigated the prevalence of dysnatremia in elderly patients without CKD in an emergency department in Japan. Read More

J Med Case Rep 2018 Dec 27;12(1):381. Epub 2018 Dec 27.

Division of Nephrology, Department of Medicine, Tygerberg Hospital and Stellenbosch University, Ward A7, Tygerberg Hospital, Francie van Zijl Drive, Parow Valley, Cape Town, 7505, South Africa.

Background: Hypernatremia is a very common electrolyte disorder and is frequently encountered in out-patient as well as in-hospital settings. We describe an adult who was found to have unexplained relative polycythemia and episodic hypernatremia. A diagnosis of idiopathic hypodipsic-hypernatremia syndrome was made and the patient was managed with a water-drinking schedule. Read More

JAMA Intern Med 2019 Feb;179(2):213-223

West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Importance: Although corticosteroids are widely used for adults with sepsis, both the overall benefit and potential risks remain unclear.

Objective: To conduct a systematic review and meta-analysis of the efficacy and safety of corticosteroids in patients with sepsis.

Data Sources And Study Selection: MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception until March 20, 2018, and updated on August 10, 2018. Read More

Vet Radiol Ultrasound 2019 Mar 21;60(2):219-232. Epub 2018 Dec 21.

Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, 95616.

Published studies on the use of stereotactic radiotherapy for dogs with pituitary tumors are limited. This retrospective observational study describes results of stereotactic radiotherapy for 45 dogs with imaging-diagnosed pituitary tumors. All dogs were treated at a single hospital during the period of December 2009-2015. Read More

Front Physiol 2018 4;9:1690. Epub 2018 Dec 4.

Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara, Brazil.

Hyperosmotic challenges trigger a hypertensive response and natriuresis mediated by central and peripheral sensors. Here, we evaluated the importance of the carotid bodies for the hypertensive and natriuretic responses to acute and sub-chronic NaCl load in conscious rats. Male Wistar rats (250-330 g) submitted to bilateral carotid body removal (CBX) or sham surgery were used. Read More

J Neonatal Perinatal Med 2019 ;12(1):103-107

Department of Pediatrics, Tulane University Health Sciences Center, New Orleans, LA, USA.

A 710 g male infant was born at a referring hospital at a gestational age of 23 weeks and 2 days via vaginal delivery and was transferred to our facility at 14 days of age. His delivery was complicated by the breech presentation with difficult head extraction. The infant's initial course was significant for respiratory distress syndrome, grade III-IV intraventricular hemorrhage (IVH), acute kidney injury, and large PDA. Read More

J Neurosurg Sci 2018 Dec 5. Epub 2018 Dec 5.

Department of Neurosurgery, State University of New York Upstate, Syracuse, NY, USA.

Background: Hypernatremia is one of the most common electrolyte disturbances following aneurysmal subarachnoid hemorrhage (aSAH) and has been correlated with increased mortality in single institution studies. We investigated this association using a large nationwide healthcare database.

Methods: We performed a retrospective analysis of adults between 2002 and 2011 with a primary diagnosis of aSAH using the Nationwide Inpatient Sample (NIS). Read More

Mymensingh Med J 2018 Oct;27(4):723-729

Dr Mrinal Kanti Das, Assistant Registrar, Department of Paediatrics, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh.

Complication of perinatal asphyxia is a major cause of neonatal mortality & morbidity in developing countries. This comparative cross sectional study was conducted in Mymensingh Medical College Hospital, Mymensingh, Bangladesh from May 2012 to September 2012 to determine electrolytes & renal function status in perinatal asphyxia & their impact on outcome. Thirty term normal birth weight babies with perinatal asphyxia in neonatal ward were included as a case group and thirty term normal birth weight neonates of same gestational age, without perinatal asphyxia in the department of Gynae & Obs were enrolled as a control group. Read More

Crit Care Resusc 2018 12;20(4):285-293

Department of Intensive and Critical Care Unit, Flinders Medical Centre, Adelaide, SA, Australia.

Background: Inadvertent fluid loading - and resultant sodium and chloride - is common in critically ill patients. Sources such as fluid used as vehicles for drug infusions and boluses (fluid creep) and maintenance fluid are a common cause. We hypothesised that total sodium and chloride loading can be safely reduced in critically ill patients both by the use of 5% glucose as a diluent for infusions and boluses, when possible, and by its use as a maintenance fluid. Read More

Trials 2018 Nov 14;19(1):628. Epub 2018 Nov 14.

Department of Critical Care Medicine, Mayo Clinic, Phoenix, AZ, 85054, USA.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition that results from a ruptured cerebral vessel. Cerebral edema and vasospasm are common complications and frequently require treatment with hypertonic solutions, in particular hypertonic sodium chloride (NaCl). We have previously shown that hyperchloremia in patients with aSAH given hypertonic NaCl is associated with the development of acute kidney injury (AKI), which leads to higher morbidity and mortality. Read More

S Afr Med J 2018 Oct 2;108(10):847-851. Epub 2018 Oct 2.

Discipline of Anaesthesiology and Critical Care Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban; and Inkosi Albert Luthuli Central Hospital, Durban, South Africa.

Background: Abnormal preoperative serum sodium measurements have been shown to be associated with increased postoperative mortality in US and European surgical populations. It is possible that such measurements are also associated with increased postoperative mortality in a South African (SA) setting, but this is yet to be confirmed. Establishing whether preoperative serum sodium measurements are associated with postoperative mortality could have implications for perioperative risk stratification in SA settings. Read More