Csipak Gabriela, Hagau Natalia
Department of Anaesthesia and Intensive Care, Emergency County Hospital, Cluj-Napoca, Romania.
"Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Rom J Anaesth Intensive Care. 2016 Oct;23(2):155-158. doi: 10.21454/rjaic.7518/232.syn.
We describe two polytrauma patients without severe head trauma who developed Cerebral Salt Wasting Syndrome (CSWS) during their stay in our ICU with natriuresis, hyponatremia and hypovolemia. Hyponatremia encountered in CSWS and the syndrome of inadequate antidiuretic hormone secretion (SIADH) is a common electrolyte finding in patients with severe head trauma, subarachnoid hemorrhage, malignancy and infections of the central nervous system. CSWS was an unexpected electrolyte finding in our patients with minor head trauma without neurological or neurosurgical problems. To rule out other causes of hyponatremia (SIADH, secondary adrenal dysfunction and thyroid dysfunction) a correct diagnosis is very important, as proper treatment of CSWS with fluid and salt replacement will decrease mortality and morbidity. In conclusion, CSWS should be suspected in any polytrauma patient with minor head trauma and hyponatremia.
我们描述了两名无严重头部创伤的多发伤患者，他们在入住我们重症监护病房期间出现了脑性盐耗综合征（CSWS），伴有尿钠增多、低钠血症和血容量不足。CSWS以及抗利尿激素分泌不足综合征（SIADH）中出现的低钠血症，是重度头部创伤、蛛网膜下腔出血、恶性肿瘤和中枢神经系统感染患者常见的电解质表现。CSWS在我们头部创伤轻微且无神经或神经外科问题的患者中是一种意外的电解质表现。为排除低钠血症的其他原因（SIADH、继发性肾上腺功能不全和甲状腺功能障碍），正确诊断非常重要，因为用液体和盐分替代对CSWS进行恰当治疗可降低死亡率和发病率。总之，任何头部创伤轻微且有低钠血症的多发伤患者都应怀疑患有CSWS。
