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Int J Chron Obstruct Pulmon Dis 2022 12;17:1143-1155. Epub 2022 May 12.

The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China.

Purpose: The purpose of our study was to investigate the relationship between serum sodium levels and 1-year and 3-year mortality in critically ill patients with comorbid chronic obstructive pulmonary disease using real-world data.

Methods: The data of this study were collected from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. First of all, we used the Kaplan-Meier curves and multivariable Cox regression analyses to measure the relationship between serum sodium levels and 1-year and 3-year mortality for critically ill patients with comorbid COPD. Read More

Eur J Endocrinol 2022 May 1. Epub 2022 May 1.

J Hofland, Internal Medicine, Erasmus MC, Rotterdam, Netherlands.

Objective: Hyponatremia and hypernatremia are common electrolyte abnormalities in patients with malignancy and have been independently associated with worse survival outcomes. To date, there are no data on the impact of dysnatremia on survival outcome in patients with neuroendocrine neoplasms (NENs).

Design: Retrospective cohort analysis from a tertiary care center of NEN patients treated with peptide receptor radionuclide therapy (PRRT) with a cumulative activity of at least 3. Read More

Cureus 2022 Apr 8;14(4):e23942. Epub 2022 Apr 8.

Internal Medicine, King Abdulaziz Medical City, Riyadh, SAU.

Osmoregulation is a fundamental process of homeostasis that maintains metabolic and biochemical reactions, thermoregulation, and fluid-electrolytes balance. Fluid-electrolytes imbalance leads to various clinical manifestations ranging from mild weakness to severe neurological dysfunction. Adipsic hypernatremia is an exceedingly rare life-threatening condition characterized by defective osmoregulatory mechanisms. Read More

Kidney Res Clin Pract 2022 Apr 13. Epub 2022 Apr 13.

Division of Nephrology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea.

Background: Hypernatremia is a common electrolyte disorder in children and elderly people and has high short-term mortality. However, no high-quality studies have examined the correction rate of hypernatremia and the amount of fluid required for correction. Therefore, in this study, we will compare the efficacy and safety of rapid intermittent bolus (RIB) and slow continuous infusion (SCI) of electrolyte-free solution in hypernatremia treatment. Read More

Saudi J Kidney Dis Transpl 2021 Sep-Oct;32(5):1431-1440

Department of Pediatric Nephrology, Bangladesh Institute of Child Health and Dhaka Shishu (Children) Hospital, Sher e Bangla Nagar, Dhaka, Bangladesh.

Our study aimed to manage the children presented with severe hypernatremic dehydration and acute kidney injury (AKI) an updated fluid management protocol was used to find out the rate of decline of serum sodium per day and their outcome. This is a prospective interventional study was conducted from November 2015 up to October 2016 in the Critical Care Nephrology and Dialysis Unit of Dhaka Shishu (Children) Hospital, Bangladesh. A total of 45 children with hypernatremia and AKI were evaluated. Read More

Cureus 2022 Mar 24;14(3):e23438. Epub 2022 Mar 24.

Nephrology, AMITA Health Saint Francis Hospital, Evanston, USA.

Lithium is a commonly used medication for mood stabilization and a well-known cause of nephrogenic diabetes insipidus (DI). Coexistent psychogenic polydipsia with nephrogenic DI is uncommon, and its management is challenging due to the wide variation in serum sodium based on fluctuations in water intake. Here, we describe the case of a 56-year-old male with psychogenic polydipsia and nephrogenic DI which manifested in wide swings of serum sodium over a short interval. Read More

Emerg Med Australas 2022 Apr 26. Epub 2022 Apr 26.

New South Wales Poisons Information Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.

Although sodium bicarbonate can be a life-saving antidote for patients with overdoses resulting in sodium channel blockade, there has been a concerning rise in cases referred to the Poisons Information Centre where inappropriately large doses of bicarbonate have been used resulting in iatrogenic harm. We present a series of three clinical cases where excessive bicarbonate was used to treat poisonings and discuss our approach to managing cardiotoxicity secondary to sodium channel blockade. Serial blood gas analysis should be performed when using bicarbonate to ensure pH targets are met and severe alkalaemia, hypernatraemia and hypokalaemia are avoided. Read More

Blood Purif 2022 Apr 25:1-11. Epub 2022 Apr 25.

Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, Ohio, USA.

Background: Pediatric sepsis is a significant public health issue. This condition is exacerbated by rising serum creatinine and inflammatory cytokines that lead to deleterious effects upon the body. The current standard of care involves the use of continuous kidney replacement therapy to remove harmful cytokines until the body returns to homeostasis. Read More

Brain Behav 2022 May 22;12(5):e2574. Epub 2022 Apr 22.

Guangdong provincial Geriatric's Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

Objectives: Hypernatremia often occurs in patients with brain death. This study summarizes its characteristics.

Methods: We recorded 57 patient's highest blood sodium value, as well as daily NT-proBNP, blood creatinine, and urine output. Read More

Front Pediatr 2022 31;10:854367. Epub 2022 Mar 31.

Almazov National Medical Research Centre, Saint Petersburg, Russia.

It is known that the SARS-CoV-2 virus may cause neurologic damage. Rapid-onset obesity, hypoventilation, hypothalamus dysfunction, and autonomic dysregulation (ROHHAD) syndrome is a disease of unknown etiology with a progressive course and unclear outcomes. The etiology of ROHHAD syndrome includes genetic, epigenetic, paraneoplastic, and immune-mediated theories, but to our knowledge, viral-associated cases of the disease have not been described yet. Read More

Clin Pediatr Endocrinol 2022 16;31(2):81-86. Epub 2022 Feb 16.

Department of Pediatrics, Chonnam National University Medical School & Children's Hospital, Gwangju, Korea.

Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are diabetic emergencies. Some patients with a hyperglycemic crisis can present with an overlap of DKA and HHS. The coexistence of DKA and HHS is associated with higher mortality than in isolated DKA and HHS. Read More

Sci Rep 2022 Apr 15;12(1):6247. Epub 2022 Apr 15.

Department of Physics, Central University of Kerala, Periye, Kasaragod, Kerala, 671316, India.

The homeostatic control of Sodium (Na) ion in the human body assumes paramount relevance owing to its physiological importance. Any deviation from the normal level causes serious health problems like hypernatremia, hyponatremia, stroke, kidney problems etc. Therefore, quantification of Na levels in body fluids has significant diagnostic and prognostic importance. Read More

Front Pharmacol 2022 29;13:844122. Epub 2022 Mar 29.

Unit Emerging Infectious Disease, Ospedali dei Colli, Naples, Italy.

Hypernatremia is a serious event that can occur during intravenous (IV) treatment with fosfomycin, and it can also be caused by a wrong drug preparation. Considering the clinical significance of hypernatremia, we decided to carry out two studies by using two different data sources with the aim to evaluate cases of IV fosfomycin-induced hypernatremia. A retrospective medical record review was performed from June 2017 to June 2019 using data from two hospitals in Southern Italy. Read More

Clin Endocrinol (Oxf) 2022 Apr 13. Epub 2022 Apr 13.

Molecular Profiling Research Center for Drug Discovery, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan.

Objective: We recently reported cases of adipsic hypernatremia caused by autoantibodies against the subfornical organ in patients with hypothalamic-pituitary lesions. This study aimed to clarify the clinical features of newly identified patients with adipsic hypernatremia whose sera displayed immunoreactivity to the mouse subfornical organ.

Design: Observational cohort study of patients diagnosed with adipsic hypernatremia in Japan, United States, and Europe. Read More

Front Endocrinol (Lausanne) 2022 21;13:840971. Epub 2022 Mar 21.

Department of Systems Medicine, Medical Oncology, Tor Vergata University of Rome, Rome, Italy.

Central diabetes insipidus (CDI) is a rare endocrine disease deriving from an insufficient production or secretion of anti-diuretic hormone. Recently, CDI has been reported as a rare side effect triggered by immune checkpoint inhibitors (ICI) in cancer patients. Despite its current rarity, CDI triggered by ICI is expected to affect an increasing number of patients because of the expanding use of these effective drugs in a growing number of solid and hematologic malignancies. Read More

Mymensingh Med J 2022 Apr;31(2):281-288

Dr Fahim Ahmad, Registrar, Paediatrics Neurology & Development, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:

Severe acute malnutrition (SAM) is the most severe form of protein energy malnutrition (PEM). Few studies found serum electrolyte, serum calcium level changes as important factors of poor outcome. Hypoglycemia is already established as a risk factor for death in severe acute malnutrition. Read More

S Afr Med J 2022 03 1;112(3):201-208. Epub 2022 Mar 1.

Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Background: Coronavirus disease (COVID-19) has imposed unprecedented stressors on South Africa (SA)'s healthcare system. Superimposed on the country's quadruple burden of disease, pandemic-related care further exposes existing inequities. Some of these inequities are specific to hospital-based inpatient services, such as the geographical maldistribution of hospital beds, lack of oxygen supplies and assisted ventilation, and scarcity of trained healthcare workers. Read More

Acta Paediatr 2022 Apr 3. Epub 2022 Apr 3.

Department of Paediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland.

Aim: The aim was to evaluate the incidence, hospitalisations and deaths in acutely ill children with dysnatraemias.

Methods: This was a register-based cohort study of 46 518 acutely ill children aged <16 years who visited a paediatric emergency department. Risk factors were assessed using two nested case-control studies. Read More

Cureus 2022 Feb 27;14(2):e22648. Epub 2022 Feb 27.

Emergency Medicine, University of the Witwatersrand, Johannesburg, Gauteng, ZAF.

Background Hypernatremia in the critical care setting is a major cause of morbidity and mortality. However, data pertaining to this has not been evaluated in South African hospitals. The aim of this study was to evaluate hypernatremia with regards to its prevalence, associated factors, and outcomes at an academic hospital intensive care unit (ICU) in Johannesburg, South Africa. Read More

Front Pharmacol 2022 17;13:759247. Epub 2022 Mar 17.

Division of Hematology/Oncology, Department of Pediatrics, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China.

Metabolic acidosis often occurs in the paediatric intensive care unit (PICU). Although sodium bicarbonate (SB) has been widely used in paediatrics, data on the effect of SB on children with metabolic acidosis in the PICU are scarce. Patients with metabolic acidosis who were treated with SB within 48 h of PICU admission were screened. Read More

J Trauma Acute Care Surg 2022 Apr 1. Epub 2022 Apr 1.

Department of Surgery, Oregon Health & Science University, Portland, Oregon.

Background: A 2-gram bolus of tranexamic acid (TXA) has been shown to reduce 28-day mortality in a RCT. This study investigates whether out-of-hospital TXA use is associated with adverse events or unfavorable outcomes in suspected TBI when intracranial hemorrhage (ICH) is absent on initial CT.

Methods: This study utilized data from a 2015-2017, multicenter, randomized trial studying the effect of the following TXA doses on moderate to severe TBI: 2-gram bolus, 1-gram bolus plus 1-gram infusion over 8 hours, and a placebo bolus with placebo infusion. Read More

Front Cardiovasc Med 2022 8;9:828015. Epub 2022 Mar 8.

School of International Business, China Pharmaceutical University, Nanjing, China.

Background: The association between hypernatremia and delirium after cardiac surgery has rarely been investigated. This study aimed to determine whether hypernatremia increases the risk of delirium after exposure.

Materials And Methods: From April 2016 to June 2021, 7,831 consecutive patients receiving cardiac surgery were screened for potential enrollment. Read More

Exp Gerontol 2022 Jun 26;163:111778. Epub 2022 Mar 26.

Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.

Objectives: Frailty is a state of increased vulnerability to poor resolution of homeostasis after a stressor. We hypothesized that frail older adults would tend to have electrolyte imbalances because they should have many stressors together with fragile physiological systems. In this study, we aimed to determine whether older adults with higher Frailty Index scores have electrolyte imbalances and to establish which domains of the Frailty Index are correlated with electrolyte imbalances. Read More

Bratisl Lek Listy 2022 ;123(3):172-177

Aim: To evaluate the effect of hypernatremia on the organization of blood plasma high density lipoproteins (HDL) in goldfish; to compare the state of hypernatremia in fish and humans; to assess the possible risks and consequences of the effect of hypernatremia on human plasma lipoproteins.

Methods: The fish were acclimated for 20 days at a critical salinity of 11.5 g/L; after that the salt water was gradually "desalinated". Read More

JFMS Open Rep 2022 Jan-Jun;8(1):20551169221082542. Epub 2022 Mar 23.

Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN, USA.

Case Summary: A 2-year-old female spayed domestic shorthair cat was presented with a history of collapse, possible hypodipsia/adipsia, severe dehydration and hypernatremia. MRI of the brain revealed a failure of separation of the cerebral hemispheres as characterized by an absence of the rostral part of the corpus callosum, fornix and septum pellucidum and the presence of a single fused lateral ventricle. A diagnosis of hypodipsic/adipsic hypernatremia with lobar holoprosencephaly was made. Read More

BMC Emerg Med 2022 03 24;22(1):49. Epub 2022 Mar 24.

Department of Internal and Emergency Medicine, Buergerspital Solothurn, Solothurn, Switzerland.

Background: Electrolyte disorders are common in the emergency department. Hyponatremia is known to be associated with adverse outcome in community-acquired pneumonia (CAP) and acute exacerbation of chronic obstructive pulmonary disease (AECOPD). No studies investigating the prevalence and influence of hypernatremia or potassium disorders in patients with AECOPD exist. Read More

Pediatr Nephrol 2022 Mar 14. Epub 2022 Mar 14.

Department of Pediatrics, Izmir University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey.

Pediatr Nephrol 2022 Mar 14. Epub 2022 Mar 14.

Department of Pediatrics, Izmir University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey.

Transplant Proc 2022 Mar 10. Epub 2022 Mar 10.

Koç University, Faculty of Medicine, Liver Transplantation Center, Istanbul, Turkey.

The relative paucity of deceased donor organs and the progressive increase in patients with cirrhosis have led transplant centers to consider organs from marginal donors (elderly donors, prolonged stay in the intensive care unit (ICU), liver steatosis-steatotic grafts, severe hypernatremia, and use of inotropes). Recently, the use of those marginal grafts has increased, but splitting liver is still debatable. Herein, we present a 28-year-old deceased donor who had a history of traumatic brain injury. Read More

Trauma Case Rep 2022 Apr 1;38:100628. Epub 2022 Mar 1.

Wake Forest School of Medicine, Department of Surgery, Winston-Salem, NC, USA.

A 34-year-old healthy male presented as a trauma activation after sustaining a gunshot wound to his face. CT head imaging was suggestive of a ballistic fragment adjacent to a posterior wall sphenoid sinus fracture with likely a small volume of adjacent blood products. He was ultimately diagnosed with hypopituitarism which included central diabetes insipidus, central hypothyroid, and adrenocorticotropic hormone deficiency secondary to cortisol deficiency. Read More