Department of Emergency Medicine, Inselspital, University of Bern, 3010 Bern, Switzerland.
J Crit Care. 2013 Apr;28(2):216.e11-20. doi: 10.1016/j.jcrc.2012.05.001. Epub 2012 Jul 2.
Hypernatremia is common in intensive care units. It has detrimental effects on various physiologic functions and was shown to be an independent risk factor for increased mortality in critically ill patients. Mechanisms of hypernatremia include sodium gain and/or loss of free water and can be discriminated by clinical assessment and urine electrolyte analysis. Because many critically ill patients have impaired levels of consciousness, their water balance can no longer be regulated by thirst and water uptake but is managed by the physician. Therefore, the intensivists should be very careful to provide the adequate sodium and water balance for them. Hypernatremia is treated by the administration of free water and/or diuretics, which promote renal excretion of sodium. The rate of correction is critical and must be adjusted to the rapidity of the development of hypernatremia.
高钠血症在重症监护病房中很常见。它对各种生理功能都有不良影响，并且已被证明是危重病患者死亡率增加的独立危险因素。高钠血症的机制包括钠的摄入和/或游离水的丢失，可以通过临床评估和尿液电解质分析来区分。由于许多重症患者意识受损，他们的水平衡不能再通过口渴和水的摄入来调节，而是由医生来管理。因此，重症监护医生应该非常小心地为他们提供适当的钠和水平衡。高钠血症通过给予自由水和/或利尿剂来治疗，这些药物可促进钠的肾脏排泄。纠正的速度是关键的，必须根据高钠血症的发展速度进行调整。
