Miller M
Division of Geriatric Medicine, Department of Medicine, Sinai Hospital of Baltimore, Maryland, USA.
Crit Care Clin. 2001 Jan;17(1):11-23, v. doi: 10.1016/s0749-0704(05)70149-4.
Hyponatremia, particularly that due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), is common in patients seen in the critical care setting. Because of aging-associated changes in the hormonal and renal systems involved in regulation of water and sodium balance, older persons are at higher risk than the young. The high prevalence of disease states and drug use in the elderly can affect water and sodium conservation and further contribute to the risk of hyponatremia in this population. The approach to management is dependent both on the severity of hyponatremia-related symptoms and the rapidity with which hyponatremia has developed. Careful monitoring of serum sodium during treatment is essential to produce prompt resolution of symptoms while avoiding the development of central pontine myelinolysis. Several therapeutic modalities are available for the longterm management of chronic hyponatremia.
低钠血症，尤其是由抗利尿激素分泌不当综合征（SIADH）引起的低钠血症，在重症监护环境中就诊的患者中很常见。由于参与水和钠平衡调节的激素和肾脏系统存在与年龄相关的变化，老年人比年轻人面临更高的风险。老年人疾病状态和药物使用的高发生率会影响水和钠的潴留，并进一步增加该人群发生低钠血症的风险。管理方法既取决于低钠血症相关症状的严重程度，也取决于低钠血症发展的速度。治疗期间仔细监测血清钠对于迅速缓解症状同时避免发生中枢性桥脑髓鞘溶解至关重要。有几种治疗方法可用于慢性低钠血症的长期管理。
