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本文引用的文献

1
Surviving Sepsis Campaign: Research Priorities for Sepsis and Septic Shock.拯救脓毒症运动：脓毒症和脓毒性休克的研究重点。
Crit Care Med. 2018 Aug;46(8):1334-1356. doi: 10.1097/CCM.0000000000003225.
2
Incidence and Trends of Sepsis in US Hospitals Using Clinical vs Claims Data, 2009-2014.2009 - 2014年美国医院中使用临床数据与索赔数据的脓毒症发病率及趋势
JAMA. 2017 Oct 3;318(13):1241-1249. doi: 10.1001/jama.2017.13836.
3
Time to Treatment and Mortality during Mandated Emergency Care for Sepsis.脓毒症强制紧急治疗的治疗时间与死亡率
N Engl J Med. 2017 Jun 8;376(23):2235-2244. doi: 10.1056/NEJMoa1703058. Epub 2017 May 21.
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Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.拯救脓毒症运动：脓毒症与脓毒性休克管理国际指南：2016版
Crit Care Med. 2017 Mar;45(3):486-552. doi: 10.1097/CCM.0000000000002255.
5
Survival Benefit and Cost Savings From Compliance With a Simplified 3-Hour Sepsis Bundle in a Series of Prospective, Multisite, Observational Cohorts.在一系列前瞻性、多中心、观察性队列研究中，遵循简化的3小时脓毒症集束化治疗方案所带来的生存获益和成本节约。
Crit Care Med. 2017 Mar;45(3):395-406. doi: 10.1097/CCM.0000000000002184.
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Risk Factors and Outcomes in Patients With Hypernatremia and Sepsis.高钠血症合并脓毒症患者的危险因素及预后
Am J Med Sci. 2016 Jun;351(6):601-5. doi: 10.1016/j.amjms.2016.01.027. Epub 2016 Mar 31.
7
Diagnosis and treatment of hypernatremia.高钠血症的诊断与治疗
Best Pract Res Clin Endocrinol Metab. 2016 Mar;30(2):189-203. doi: 10.1016/j.beem.2016.02.014. Epub 2016 Mar 4.
8
Systematic Bias in Meta-Analyses of Time to Antimicrobial in Sepsis Studies.脓毒症研究中抗菌药物使用时间的Meta分析中的系统偏倚
Crit Care Med. 2016 Apr;44(4):e234-5. doi: 10.1097/CCM.0000000000001512.
9
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).《脓毒症及脓毒性休克第三次国际共识定义（脓毒症-3）》
JAMA. 2016 Feb 23;315(8):801-10. doi: 10.1001/jama.2016.0287.
10
Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).制定脓毒性休克的新定义并评估新的临床标准：用于第三次脓毒症和脓毒性休克国际共识定义（Sepsis-3）。
JAMA. 2016 Feb 23;315(8):775-87. doi: 10.1001/jama.2016.0289.

重症监护病房中脓毒症和脓毒性休克患者高钠血症的患病率及预后影响：单中心经验

Prevalence and Prognostic Impact of Hypernatremia in Sepsis and Septic Shock Patients in the Intensive Care Unit: A Single Centre Experience.

作者信息

Shirazy Mohamed, Omar Islam, Abduljabbar Duaa, Bousselmi Kamel, Alkhaja Maryam, Chaari Anis, Kauts Vipin, Hakim Karim

机构信息

Emergency Department, University Hospitals of Morecambe Bay NHS Foundation Trust, Burton United Kingdom.

Critical Care Department, King Hamad University Hospital, Kingdom of Bahrain Bahrain.

出版信息

J Crit Care Med (Targu Mures). 2020 Jan 31;6(1):52-58. doi: 10.2478/jccm-2020-0001. eCollection 2020 Jan.

DOI:10.2478/jccm-2020-0001
PMID:32104731
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7029404/
Abstract

INTRODUCTION

Hypernatremia is a commonly associated electrolyte disturbance in sepsis and septic shock patients in the ICU. The objective of this study was to identify the prognostic value of hypernatremia in sepsis and septic shock.

MATERIAL AND METHODS

A prospective study conducted on sepsis and septic shock patients diagnosed prior to admission in the ICU in King Hamad University Hospital, Bahrain from January 1st 2017 to February 28th 2019. Data including age, sex, comorbidities, source of sepsis, sodium levels on days one, three, and seven. Data was correlated with the outcome (survival/death and the length of ICU stay).

RESULTS

Patients included were 168, 110 survived, and 58 died. Hypernatraemia at day seven was associated with significantly higher mortality (P= 0.03). Hypernatraemia at Day1was associated with a significantly prolonged stay in the ICU (p= 0.039).Multivariate analysis to identify the independent predictors of mortality revealed that immunosuppression and hypernatraemia at Day7 proved to be independent predictors of mortality (P= 0.026 and 0.039 respectively).

CONCLUSION

Hypernatremia can be an independent predictor of poor outcome in septic and septic shock patients in the ICU.

摘要

引言

高钠血症是重症监护病房（ICU）中脓毒症和脓毒性休克患者常见的电解质紊乱。本研究的目的是确定高钠血症在脓毒症和脓毒性休克中的预后价值。

材料与方法

对2017年1月1日至2019年2月28日在巴林哈马德王大学医院ICU入院前诊断为脓毒症和脓毒性休克的患者进行前瞻性研究。数据包括年龄、性别、合并症、脓毒症来源、第1天、第3天和第7天的钠水平。数据与结局（生存/死亡和ICU住院时间）相关。

结果

纳入患者168例，110例存活，58例死亡。第7天的高钠血症与显著更高的死亡率相关（P = 0.03）。第1天的高钠血症与ICU住院时间显著延长相关（p = 0.039）。多因素分析确定死亡率的独立预测因素显示，免疫抑制和第7天的高钠血症被证明是死亡率的独立预测因素（分别为P = 0.026和0.039）。

结论

高钠血症可能是ICU中脓毒症和脓毒性休克患者预后不良的独立预测因素。