CLINICAL SPECTRUM OF HYPONATRAEMIA IN MEDICINE ICU OF DMCH
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 73
Abstract
BACKGROUND Hyponatraemia is one of the most common disorder of electrolytes encountered in a clinical setting of Intensive Care Unit. There has been no consensus on optimal management of hyponatraemia. Despite knowledge of hyponatraemia being a common disorder, high mortality among the patients is secondary to the underlying medical conditions rather than the degree of hyponatraemia. The objective of this study is to assess the incidence, aetiological factors, clinical manifestations, treatment outcomes and complications of hyponatraemia in Medical ICU of Darbhanga Medical College, Laheriasarai. MATERIALS AND METHODS This study was a descriptive study. Admitted patients whose serum electrolytes had been estimated in the ICU of Dept. of Medicine, Darbhanga Medical College, Laheriasarai in the period from 01 Dec. 2014 to 31 July 2016, were evaluated. Patients with a serum sodium concentration < 135 mEq/L during the admission period were included in the study. RESULTS Out of 614 patients admitted in ICU, 102 patients developed hyponatraemia (17.58% incidence). Study included 100 patients. Symptoms included lethargy (33%), postural dizziness and abnormal behaviour. Most common aetiological factor came out to be liberal use of diuretics (35%) vomiting, gastroenteritis and febrile illness. Pre-existing illnesses associated with hyponatraemia were maximum with previous history of hypertension (58%), diabetes (40%) and chronic kidney disease (18%). Major treatment modality included normal saline (64%) either for treatment or as a part of fluid therapy, salt supplements and water restriction. One patient developed treatment related complications. A total of 19 patients died in this study including 7 patients with severe hyponatraemia. CONCLUSION The possible cause of hyponatraemia should always be sought as outcome in severe hyponatraemia, is governed by aetiology and not by the serum sodium level. Treatment of severe symptomatic hyponatraemia with hypertonic saline is safe if recommendation for the rate of correction of hyponatraemia is strictly followed.
Authors and Affiliations
Umesh Chandra Jha, Manish Kumar
Keywords
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- EP ID EP265849
- DOI 10.14260/Jemds/2017/1141
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