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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

Frequency: Monthly

ISSN 0375-9393

Online ISSN 1827-1596


Minerva Anestesiologica 2006 June;72(6):353-6

SMART 2006 - Milan, May 10-12, 2006 

Hyponatremia, hypernatremia: a physiological approach

Offenstadt G. 1, Das V. 2

1 Medical Intensive Care Unit Hôpital Saint-Antoine, Paris, France
2 Epidemiology Research Unit Systèmes d'Information et Modélisation INSERM (U707), Paris, France

Natremia belongs to the toolbox of the practicing intensivist. It is an indicator of the hydration status, which is an item that must be continuously monitored in critically ill patients. Hyponatremia is not rare (1% to 2% of hospitalised patients), and hypernatremia is about 10 times less frequent while hypernatremia always indicates hypertonicity, hyponatremia is not equivalent to hypotonicity. Diagnosis depends on the history, clinical examination and basic biochemical data. It should be kept in mind that obtaining urine samples is as important as plasma samples in this respect. The first step consists in confirming that hyponatremia is hypotonic. The second step is to assess the renal response to hypotonicity. Hypotonic hyponatremia will be considered in association with hypovolemia, euvolemia or hypervolemia. The constitution of a hyperosmolar state requires an inadequate water intake The main goal of the treatment is not to normalize numbers (they must always be checked first), but to treat symptoms. Tolerance must always be appreciated. The mathematical formulas proposed are of interest for a better understanding, but should not be followed strictly.

language: English


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