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Hypernatremia

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Evidence-Based Critical Care

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Abstract

Hypernatremia is common in the critically ill. Etiology is most often related to high free water losses and or inadequate free water repletion. Diagnosis can be made with serum sodium and evaluation of patient story, course, and medication history. Free water repletion amounts are determined by using formulas to calculate free water deficit and ongoing free water loss. The most important management issue is to ensure adequate free water replacement during ongoing free water losses in the setting of a free water deficit.

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References

  1. Lindner G, Funk GC, Schwarz C, et al. Hypernatremia in the critically ill is an independent risk factor for mortality. Am J Kidney Dis. 2007;50(6):952–7.

    Article  Google Scholar 

  2. Funk GC, Lindner G, Druml W, et al. Incidence and prognosis of dysnatremias present on ICU admission. Intensive Care Med. 2010;36(2):304–11.

    Article  Google Scholar 

  3. Lindner G, Kneidinger N, Holzinger U, Druml W, Schwarz C. Tonicity balance in patients with hypernatremia acquired in the intensive care unit. Am J Kidney Dis. 2009;54(4):674–9.

    Article  CAS  Google Scholar 

  4. Namdar T, Stollwerck PL, Stang FH, et al. Progressive fluid removal can avoid electrolyte disorders in severely burned patients. Ger Med Sci. 2011;9:Doc13.

    PubMed  PubMed Central  Google Scholar 

  5. Mamtani A, Odom SR, Butler KL. Diabetes insipidus uncovered during conservative management of complicated acute appendicitis. Clin Case Rep. 2016;4(5):491–3.

    Article  Google Scholar 

  6. Blum D, Brasseur D, Kahn A, Brachet E. Safe oral rehydration of hypertonic dehydration. J Pediatr Gastroenterol Nutr. 1986;5(2):232–5.

    Article  CAS  Google Scholar 

  7. Kahn A, Brachet E, Blum D. Controlled fall in natremia and risk of seizures in hypertonic dehydration. Intensive Care Med. 1979;5(1):27–31.

    Article  CAS  Google Scholar 

  8. Sterns RH. Evidence for managing hypernatremia. is it just hyponatremia in reverse? Clin J Am Soc Nephrol. 2019;14(5):645–7.

    Article  Google Scholar 

  9. Shah MK, Mandayam S, Adrogue HJ. Osmotic demyelination unrelated to hyponatremia. Am J Kidney Dis. 2018;71(3):436–40.

    Article  Google Scholar 

  10. Ostermann M, Dickie H, Tovey L, Treacher D. Management of sodium disorders during continuous haemofiltration. Crit Care. 2010;14(3):418.

    Article  Google Scholar 

  11. Park HS, Hong YA, Kim HG, et al. Usefulness of continuous renal replacement therapy for correcting hypernatremia in a patient with severe congestive heart failure. Hemodial Int. 2012;16(4):559–63.

    Article  Google Scholar 

  12. Paquette F, Goupil R, Madore F, Troyanov S, Bouchard J. Continuous venovenous hemofiltration using customized replacement fluid for acute kidney injury with severe hypernatremia. Clin Kidney J. 2016;9(4):540–2.

    Article  Google Scholar 

  13. Fulop T, Zsom L, Rodriguez RD, Chabrier-Rosello JO, Hamrahian M, Koch CA. Therapeutic hypernatremia management during continuous renal replacement therapy with elevated intracranial pressures and respiratory failure. Rev Endocr Metab Disord. 2019;20(1):65–75.

    Article  Google Scholar 

  14. Pokaharel M, Block CA. Dysnatremia in the ICU. Curr Opin Crit Care. 2011;17(6):581–93.

    Article  Google Scholar 

  15. Polderman KH, Schreuder WO, Strack van Schijndel RJ, Thijs LG. Hypernatremia in the intensive care unit: an indicator of quality of care? Crit Care Med. 1999;27(6):1105–8.

    Article  CAS  Google Scholar 

  16. Darmon M, Timsit JF, Francais A, et al. Association between hypernatraemia acquired in the ICU and mortality: a cohort study. Nephrol Dial Transplant. 2010;25(8):2510–5.

    Article  CAS  Google Scholar 

  17. Sam R, Hart P, Haghighat R, Ing TS. Hypervolemic hypernatremia in patients recovering from acute kidney injury in the intensive care unit. Clin Exp Nephrol. 2012;16(1):136–46.

    Article  Google Scholar 

  18. Truche AS, Ragey SP, Souweine B, et al. ICU survival and need of renal replacement therapy with respect to AKI duration in critically ill patients. Ann Intensive Care. 2018;8(1):127.

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Renal Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Kenneth B. Christopher

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  1. Kenneth B. Christopher
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Correspondence to Kenneth B. Christopher .

Editor information

Editors and Affiliations

  1. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Robert C. Hyzy

  2. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Jakob McSparron

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Christopher, K.B. (2020). Hypernatremia. In: Hyzy, R.C., McSparron, J. (eds) Evidence-Based Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-26710-0_49

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  • DOI: https://doi.org/10.1007/978-3-030-26710-0_49

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-26709-4

  • Online ISBN: 978-3-030-26710-0

  • eBook Packages: MedicineMedicine (R0)

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