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Báo cáo y học: " Sodium and brain injury: do we know what we are doing"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Sodium and brain injury: do we know what we are doing? | Available online http ccforum.eom content 13 5 184 Commentary Sodium and brain injury do we know what we are doing David A Zygun Departments of Critical Care Medicine Clinical Neurosciences and Community Health Sciences University of Calgary EG23e 1403-29 Street NW Calgary AB Canada T2N2T9 Corresponding author David A Zygun dzygun@ucalgary.ca Published 3 September 2009 This article is online at http ccforum.com content 13 5 184 2009 BioMed Central Ltd Critical Care 2009 13 184 doi 10.1186 cc8014 See related research by Maggiore et al. http ccforum.com content 13 4 R110 Abstract There is mounting evidence including the recent report by Maggiore and colleagues of an association between hypernatremia and mortality in patients with traumatic brain injury. This mandates a re-evaluation of routine administration of agents such as hypertonic saline for the management of intracranial hypertension in those with traumatic brain injury. In the previous issue of Critical Care Maggiore and colleagues 1 contributed significantly to our understanding of the incidence and associated consequences of hypernatremia in neurocritical care. This retrospective cohort study was performed in 130 consecutive patients with severe traumatic brain injury admitted to a tertiary academic referral institution. Hypernatremia was common occurring in 51.5 of patients for 31 of the duration of their intensive care unit ICU stay. Hypernatremia was associated with a threefold increase in hazard of ICU death even after adjustment for baseline risk. These results are consistent with the previous work of Aiyagari and colleagues 2 who found that hypernatremia was independently associated with increased mortality but only when severe serum sodium 160 mEq L in a mixed neurocritical care sample that included patients with traumatic brain injury. It is important to note that these non-interventional studies employed rigorous analytic techniques to account for the etiology of sodium disturbance. Such complex .