Flinders Medical Centre, Adelaide, SA, Australia.
Crit Care Resusc. 2012 Mar;14(1):33-7.
Recommended daily intake of sodium is 1- 2mmol/kg. Sodium administration is rarely separated from fluid administration in critically ill patients.
To estimate the amount of sodium administered to patients who were invasively ventilated, and to investigate whether sodium administration affected oxygenation, length of stay in ICU and serum sodium level.
DESIGN, PARTICIPANTS AND SETTING: Retrospective audit of adult patients who received invasive mechanical ventilation for ≥ 5 days in a tertiary-level intensive care unit.
Total sodium administered from resuscitation and maintenance fluids, infusions, flushes, medicines, transfusions, enteral feeds and total parenteral nutrition; oxygenation, length of ICU stay and serum sodium level.
13 men and 7 women were included. Their median age was 71.9 years (range, 19.8-89.2 years). Median duration of mechanical ventilation was 9 days (range, 6-20 days) and median ICU stay 11.6 days (range, 6-21 days). Median APACHE II score was 29 (range, 18-41). Daily sodium administration was 225.5mmol (151-355mmol). The median daily net fluid balance was 351mL (range, - 759 to +1125mL) and median daily fluid intake was 2352mL (range, 1437- 3798mL). Daily sodium administered correlated with net fluid balance (P<0.001; r=0.35). Of total sodium administered, infusions contributed 22.2% (1.2%-39.9%); drugs 21.6% (0.0-35.5%); flushes 17.4% (9.3%-24.5%); enteral feeds 17% (0.0-39.5%); resuscitation 16.0% (2.5%-36.9%); maintenance fluids 5.8% (0.0-24.0%); transfusions 3.9% (0.0-9.5%) and parenteral nutrition 0.1% (0.0-2.6%).
Sodium administration to this cohort of critically ill patients requiring prolonged mechanical ventilation was high. Further studies should examine ways of limiting the amount of sodium administered to such patients and to examine if this influences patient outcomes.
建议的每日钠摄入量为 1-2mmol/kg。危重症患者的钠给药很少与液体给药分开。
估计接受有创机械通气的患者给予的钠量，并研究钠给药是否影响氧合、 ICU 住院时间和血清钠水平。
设计、参与者和设置：对在三级重症监护病房接受有创机械通气≥5 天的成年患者进行回顾性审核。
复苏和维持液、输液、冲洗液、药物、输血、肠内喂养和全胃肠外营养中给予的总钠量；氧合、 ICU 住院时间和血清钠水平。
纳入 13 名男性和 7 名女性，中位年龄为 71.9 岁（范围 19.8-89.2 岁）。机械通气中位时间为 9 天（范围 6-20 天），ICU 中位住院时间为 11.6 天（范围 6-21 天）。中位急性生理和慢性健康评分 II 为 29（范围 18-41）。每日钠摄入量为 225.5mmol（151-355mmol）。中位每日净液体平衡为 351mL（范围-759 至+1125mL），中位每日液体摄入量为 2352mL（范围 1437-3798mL）。每日给予的钠量与净液体平衡相关（P<0.001；r=0.35）。在给予的总钠中，输液占 22.2%（1.2%-39.9%）；药物占 21.6%（0.0-35.5%）；冲洗液占 17.4%（9.3%-24.5%）；肠内喂养占 17%（0.0-39.5%）；复苏液占 16.0%（2.5%-36.9%）；维持液占 5.8%（0.0-24.0%）；输血占 3.9%（0.0-9.5%）；肠外营养占 0.1%（0.0-2.6%）。
需要长时间机械通气的危重症患者给予的钠量较高。进一步的研究应探讨限制此类患者给予的钠量的方法，并研究这是否会影响患者的结局。
