1.Study on clinical features and management of hypernatremia in Pediatric Intensive Care Unit
Journal of Practical Medicine 2002;435(11):41-45
The study involved 47 patients with hypernatremia who have clinical symptoms and the blood sodium level more than 150 mmol/l between January 1998 and June 2001. Results: hypernatremia is observed at the Intensive Care Unit with rate of 2.7%. It is more likely to occur in 1-year children. It can be required during hospitalization and developed in the patients who are using manitol, bicarbonate sodium and diuretics. The central nervous symptoms include seizures, increase in muscular tone, unconsciousness, coma, fever and dehydration. 31.9% of patients high and very high blood sodium level. The treatment has low effect on patients who have blood sodium level more than 170 mmol/l. The average time to normalize sodium level is 1.8 days with amount of solution during 4 to 6 hours to correct Na+ level is 19.8 ml/kg/h. During subsequent hours, amount of solution is different depending on body fluid disorder of patient.
Hypernatremia
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Sodium
2.Successful treatment in the patient with serum sodium level greater than 200mEq/L.
Young Joon PARK ; Young Chan KIM ; Mi Ok KIM ; Jun Ho RUY ; Sang Woong HAN ; Ho Jung KIM
Journal of Korean Medical Science 2000;15(6):701-703
Hypernatremia developing in nonhospitalized adults is predominantly a disease of the elderly and mentally handicapped patients, possibly revealing inadequate nursing care of these patients. It has long been claimed that the duration of hypernatremia and its rate of correction are correlated with improvement in patients' neurologic status. Since there are only a handful of cases with serum sodium levels greater than 200 mEq/L until recently, it is not clear at what rate plasma sodium concentration can be safely normalized in severe hypernatremic patients. We report a case of severe hypernatremia with survival. This patient underwent rapid correction of serum sodium concentration during the management of this metabolic derangement using isotonic solution.
Journal Article
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Female
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Human
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Hypernatremia/therapy*
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Hypernatremia/physiopathology
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Hypernatremia/blood
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Middle Age
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Sodium/blood*
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Treatment Outcome
3.Long-term safety of PEG 4000 in children with chronic functional constipation: A biochemical perspective.
Korean Journal of Pediatrics 2010;53(7):741-744
PURPOSE: To evaluate the long-term safety of polyethylene glycol (PEG) 4000 in children with constipation, particularly the biochemical aspects of safety. METHODS: Medical records were evaluated, and 100 children, who had been taking PEG 4000 for more than 6 months, and who had been under clinical and biochemical monitoring, were enrolled. Ages; 6.11+/-3.12 years, Duration of therapy; 16.93+/-7.02 months, dose of PEG 4000; 0.72+/-0.21 g/kg/d. RESULTS: None of the children complained of clinical adverse effect. The first biochemical test was performed at 8.05 months after beginning of PEG 4000. Serum phosphate (SP) value was high in 10 children, and leucopenia was noted in one child. The second test was performed in 44 children at 7.57 months after the first test. The SP value was high in four children, including the three children whose initial SP value was high and one new child. Six out of 10 children with high initial SP value became normal and one was lost. Hypernatremia was noted in one child. The third test was done in 15 children at 7.5 months after the second test. The SP value of the new child from the second test was high, but became normal after finishing treatment. Two out of 3 children with high SP value at the second test became normal and one was lost. The fourth test was done in 2 children few months after the third test. All of the results were normal. There were no relation between duration of therapy and hyperphosphatemia, or between dose of PEG 4000 and hyperphosphatemia. CONCLUSIONS: PEG 4000 is safe for long-term therapy in children with constipation with respect to biochemical parameters.
Child
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Constipation
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Humans
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Hypernatremia
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Hyperphosphatemia
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Medical Records
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Polyethylene Glycols
4.Clinical Characteristics of Hypernatremia.
Jeong Hoon KIM ; Un Sil JEON ; Jin Suk HAN ; Jae Seok YANG ; Seo Jin LEE ; Curie AHN ; Suhnggwon KIM ; Jung Sang LEE ; Woo Seong HUH ; Jong Ho LEE
Korean Journal of Nephrology 1998;17(4):553-558
Hypematremia is a rare but important medical condition and is associated with mortality rate of 40 to 70%. However, little has been known about its prognostic factors or treatment guidlines. To evaluate the prognostic factors and the outcome following treatment, we reviewed 22 available medical records among twenty five hypernatremic patients (0.2%) in 12841 admissions at medical ward from January to December 1995. We defined hypernatremia as serum sodium concentration more than or equal to 150 mEq/L. Of these patients, two had hypematrernia at admission and the remaining patients became hypernatremic during admission. Mean peak serum sodium concentration was 158 (150-178) mEq/L and mean total body water deficit was 11.4 (6.7-21.3)%. Factors correlated with the development of hypernatremia were diverse and multiple, and the most frequent factor was diminished access to water. Mortality rate was 59%, but mortality was not correlated with age, correction rate of hyper-natremia, primary route of fluid loss, and the severity of hypernatremia or total body water deficit. Mortality rate was higher in patients whose serum sodium concentrations were below 130 mEq/L at admission (P<0.05). In our study, development of hypernatremia from initial hyponatremic state was significantly associated with poor outcome, and age, rapidity of correction, route of fluid loss, and the severity of hypernatremia or total body water deficit were not.
Body Water
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Humans
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Hypernatremia*
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Medical Records
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Mortality
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Sodium
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Water
5.Exclusive breastfeeding: all merits and no peril?
Soumya TIWARI ; Sushma NANGIA ; Arvind SAILI
Annals of the Academy of Medicine, Singapore 2013;42(8):413-414
Breast Feeding
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Female
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Humans
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Hypernatremia
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etiology
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therapy
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Infant, Newborn
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Male
6.A Case of Hypernatremia by Folk Remedies in a CRF Patient.
Jin Su JANG ; Hye Min CHOI ; Young Youl HYUN ; Bo Sung KWON ; Jae Youn PARK ; Jung Ha KIM ; Jae Won LEE ; Ji Eun LEE ; Young Joo KWON ; Heui Jung PYO
Korean Journal of Nephrology 2006;25(4):675-679
We report a case of chronic hypernatremia caused by excessive salt intake as folk remedies for three months. The patient had chronic tubulointerstitial nephritis (CTIN), but without documented cognitive or psychiatric disorders. She presented with severe hypernatremia 189 mmol/L and general weakness. Fluid therapy was done initially with isotonic and then with 0.45% hypotonic saline until serum sodium level reached to 157 mmol/L. Finally hemodialysis was supplemented to achieve normal serum sodium level, and she recovered without any sequelae. This report might be the first case of chronic hypernatremia due to voluntary ingestion of excessive salt in an adult patient with CTIN but without cognitive or psychiatric disorders.
Adult
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Eating
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Fluid Therapy
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Humans
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Hypernatremia*
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Medicine, Traditional*
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Nephritis, Interstitial
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Renal Dialysis
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Sodium
7.Successful Treatment of Severe Lactic Acidosis by Continuous Venovenous Hemodiafiltration.
Jin Ho KWAK ; Jung Hoon SUNG ; Kyu Bok JIN ; Eun Ah HWANG ; Seung Yeup HAN ; Sung Bae PARK ; Hyun Chul KIM
Korean Journal of Nephrology 2006;25(4):661-667
Lactic acidosis is often associated with a strikingly high mortality. The effective therapy involves treatment of the underlying cause and correction of acidemia by infusion of sodium bicarbonate. When lactic acidosis is accompanied by oliguric renal failure, bicarbonate therapy becomes more complex with volume overload and hypernatremia. Hemodialysis against a bicarbonate-buffered dialysate will achieve this. However, it is generally tolerated poorly by hemodynamically unstable patients. We report here three hemodynamically unstable patients with severe lactic acidosis, which was treated successfully by the use of continuous venovenous hemodiafiltration with bicarbonate based dialysate and replacement solution. We would suggest that continuous renal replacement with bicarbonate buffer should be indicated in the treatment of severe lactic acidosis.
Acidosis, Lactic*
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Hemodiafiltration*
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Humans
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Hypernatremia
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Mortality
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Renal Dialysis
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Renal Insufficiency
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Sodium Bicarbonate
8.A case of hypodipsic hypernatremia.
Seung Hee PARK ; Hong Sin JEON ; Sun Hwa KIM ; Don Hee AHN
Journal of the Korean Pediatric Society 1993;36(11):1621-1625
Hypodipsic hypernatremia is characterized by chronic or recurrent episodes of severe hypernatermia associated with dehydration and a lack of thirst. This constellation of deficits suggests that the syndrome is due to hypodipsia of destruction of the hypothalamic osmoreceptors that regulate thirst and ADH secretion. We report a child with abnormalities of the central nervous system who had hypernatremia and a lack of thirst without detectable abnormalities in the osmoregulation of ADH secretion. The patient was a 11 month old female and her chief complaints were poor oral intake and weight gain. There were recurrent hypernatremia with hyperosmosis and normal level of plasma ADH. With intravenous rehydratin, oral intake was improved and plasma sodium level decreased.
Central Nervous System
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Child
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Dehydration
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Female
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Humans
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Hypernatremia*
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Infant
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Osmoregulation
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Plasma
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Sodium
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Thirst
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Weight Gain
9.Acute Symptomatic Seizures Caused by Electrolyte Disturbances.
Raffaele NARDONE ; Francesco BRIGO ; Eugen TRINKA
Journal of Clinical Neurology 2016;12(1):21-33
In this narrative review we focus on acute symptomatic seizures occurring in subjects with electrolyte disturbances. Quite surprisingly, despite its clinical relevance, this issue has received very little attention in the scientific literature. Electrolyte abnormalities are commonly encountered in clinical daily practice, and their diagnosis relies on routine laboratory findings. Acute and severe electrolyte imbalances can manifest with seizures, which may be the sole presenting symptom. Seizures are more frequently observed in patients with sodium disorders (especially hyponatremia), hypocalcemia, and hypomagnesemia. They do not entail a diagnosis of epilepsy, but are classified as acute symptomatic seizures. EEG has little specificity in differentiating between various electrolyte disturbances. The prominent EEG feature is slowing of the normal background activity, although other EEG findings, including various epileptiform abnormalities may occur. An accurate and prompt diagnosis should be established for a successful management of seizures, as rapid identification and correction of the underlying electrolyte disturbance (rather than an antiepileptic treatment) are of crucial importance in the control of seizures and prevention of permanent brain damage.
Brain
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Diagnosis
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Electroencephalography
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Epilepsy
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Humans
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Hypernatremia
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Hypocalcemia
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Hyponatremia
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Seizures*
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Sensitivity and Specificity
;
Sodium
10.Central pontine myelinolysis in a patient with persistent mild hypernatremia following cadaver donor liver transplantation.
Sang Hoon YOON ; Ji Yong PARK ; Sung Uk CHOI ; Seung Zhoo YOON ; Hye Won LEE
Korean Journal of Anesthesiology 2013;65(1):87-88
No abstract available.
Cadaver
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Humans
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Hypernatremia
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Liver
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Liver Transplantation
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Myelinolysis, Central Pontine
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Tissue Donors