Furthermore, none of the patients developed hypernatraemia
. This is due to the composition of our substitution fluid, which contains sodium in a physiological concentration of 140 mmol/l, whereas other systems using separate trisodium citrate infusions adopted sodium bicarbonate or lactate-based substitution fluids supplying extra sodium.
No significant differences were found in serum urea in the patients with hyponatraemia, normal serum sodium or hypernatraemia
. None had oedema or dehydration, suggesting fluid balance was normal.
This may explain why hypernatraemia
and an altered level of consciousness were more prevalent in HDKA than NHDKA admissions.
Conditions specific to prolonged exercise include heatstroke, hypoglycaemia, hypernatraemia
associated with a reduction in total body water, postural hypotension, or exercise-associated hyponatraemia (EAH) associated with an increase in total body water.
Worldwide, there are no randomised controlled trials that have assessed the rate at which hypernatraemia
should be corrected, or how this should be achieved.
The patient was subsequently admitted to the intensive care unit (ICU) because of inability to correct her electrolyte imbalance, especially the hypernatraemia
. She received the following IV fluids in the ICU: magnesium sulphate, potassium phosphate, 5% dextrose infusion, and 0.45% saline mixed with 5% dextrose.
Their findings, published in the Journal of the Royal Society of Medicine, suggested 12% of nursing home residents presented with hypernatraemia
- high sodium levels associated with a lack of fluids - against 1.3% of others.
Ahmed, "Consequences of hyponatraemia and hypernatraemia
in children with acute diarrhoea in Bangladesh," British Medical Journal, vol.
(2) One litre of normal saline contains more than the daily requirement of sodium (70-100mmol/day), so where there is no sodium deficit, it is possible to generate hypernatraemia
with repeated infusions.
This treatment comprised optimization of sedation with nonbarbiturate anaesthetics, osmotherapy (including controlled hypernatraemia
), and maintenance of MAP by means of norepinephrine.
The extract may also interact with specific hormone receptors resulting in increased production of aldosterone and mineralocorticoids which may be responsible for the observed hypernatraemia
. Furthermore, the marked elevation in serum urea level in this study may suggest that the extract caused renal impairment in the rats or it may be a result of increased protein catabolism.
He died of water deficit and hypernatraemia
, a medical term for dehydration, three days after he was admitted to hospital.