危重症患者的尿崩症和抗利尿激素分泌不当综合征。
Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone in Critically Ill Patients.
机构信息
Intensive Care Unit, Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia; Department of Anesthesiology and Surgical Intensive Care, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Sud, Université Paris Saclay, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France.
Intensive Care Unit, Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia.
出版信息
Crit Care Clin. 2019 Apr;35(2):187-200. doi: 10.1016/j.ccc.2018.11.001. Epub 2019 Jan 28.
Diabetes insipidus and the syndrome of inappropriate antidiuretic hormone secretion lie at opposite ends of the spectrum of disordered renal handling of water. Whereas renal retention of water insidiously causes hypotonic hyponatremia in syndrome of inappropriate antidiuretic hormone secretion, diabetes insipidus may lead to free water loss, hypernatremia, and volume depletion. Hypernatremia and hyponatremia are associated with worse outcomes and longer intensive care stays. Moreover, pathologies causing polyuria and hyponatremia in patients in intensive care may be multiple, making diagnosis challenging. We provide an approach to the diagnosis and management of these conditions in intensive care patients.
尿崩症和抗利尿激素分泌不当综合征位于肾脏水代谢紊乱谱的两端。抗利尿激素分泌不当综合征中，肾脏对水的潴留会逐渐导致低渗性低钠血症，而尿崩症则可能导致自由水丢失、高钠血症和血容量减少。高钠血症和低钠血症与更差的结局和更长的重症监护停留时间相关。此外，重症监护患者多尿和低钠血症的病因可能多种多样，这使得诊断具有挑战性。我们提供了一种针对重症监护患者这些病症的诊断和治疗方法。
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