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脑死亡患者的高钠血症。

Hypernatremia in brain-dead patients.

机构信息

Guangdong provincial Geriatric's Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

出版信息

Brain Behav. 2022 May;12(5):e2574. doi: 10.1002/brb3.2574. Epub 2022 Apr 22.

DOI:10.1002/brb3.2574
PMID:35452564
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9120892/
Abstract

OBJECTIVES

Hypernatremia often occurs in patients with brain death. This study summarizes its characteristics.

METHODS

We recorded 57 patient's highest blood sodium value, as well as daily NT-proBNP, blood creatinine, and urine output. Further, we analyzed the time of the first rise in blood sodium, and the relationship between NT-proBNP, serum creatinine, urine output, and serum sodium.

RESULTS

There was no hyponatremia in these patients, and only seven of the 53 patients registered blood sodium between 137 and 150 mmol/L. We found that blood sodium started to rise at 36.0 (28.5-52.3) h, reaching the highest value in 79.0 (54.0-126.0) h. Urine volume and creatinine have no correlation with serum sodium level, while NT-proBNP has a significant correlation with serum sodium level.

CONCLUSION

It is necessary to conduct volume assessments and urine electrolyte testing on patients with brain death. BNP has a protective effect on water and electrolytes to prevent hypernatremia.

摘要

目的

脑死亡患者常发生高钠血症。本研究总结了其特征。

方法

我们记录了 57 例患者的最高血钠值，以及每日 NT-proBNP、血肌酐和尿量。此外，我们分析了血钠首次升高的时间，以及 NT-proBNP、血清肌酐、尿量与血清钠之间的关系。

结果

这些患者中没有低钠血症，53 例患者中只有 7 例血钠值在 137 至 150mmol/L 之间。我们发现血钠在 36.0（28.5-52.3）小时开始升高，在 79.0（54.0-126.0）小时达到最高值。尿量和肌酐与血清钠水平无相关性，而 NT-proBNP 与血清钠水平有显著相关性。

结论

对脑死亡患者进行容量评估和尿电解质检查非常必要。BNP 对水和电解质有保护作用，可预防高钠血症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6e/9120892/14303cd29425/BRB3-12-e2574-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6e/9120892/3d3298c3130b/BRB3-12-e2574-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6e/9120892/68b0c331c0fe/BRB3-12-e2574-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6e/9120892/2302d8af3cf8/BRB3-12-e2574-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6e/9120892/8f4cc48361fd/BRB3-12-e2574-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6e/9120892/4d7e33dd1d4d/BRB3-12-e2574-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6e/9120892/14303cd29425/BRB3-12-e2574-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6e/9120892/3d3298c3130b/BRB3-12-e2574-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6e/9120892/68b0c331c0fe/BRB3-12-e2574-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6e/9120892/2302d8af3cf8/BRB3-12-e2574-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6e/9120892/8f4cc48361fd/BRB3-12-e2574-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6e/9120892/4d7e33dd1d4d/BRB3-12-e2574-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6e/9120892/14303cd29425/BRB3-12-e2574-g007.jpg

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本文引用的文献

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Stroke. 2015 Jul;46(7):2032-60. doi: 10.1161/STR.0000000000000069. Epub 2015 May 28.
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Sodium sensing in the brain.
大脑中的钠感知
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Comparison of the European and Japanese guidelines for the acute management of intracerebral hemorrhage.欧洲和日本脑出血急性管理指南比较。
Cerebrovasc Dis. 2013;35(5):419-29. doi: 10.1159/000351754. Epub 2013 May 23.
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Alterations in serum osmolality, sodium, and potassium levels after repeated mannitol administration.反复给予甘露醇后血清渗透压、钠和钾水平的变化。
J Neurosci Nurs. 2010 Aug;42(4):201-7. doi: 10.1097/jnn.0b013e3181e26b4a.
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Autoimmunity to the sodium-level sensor in the brain causes essential hypernatremia.大脑中钠离子传感器自身免疫导致原发性高钠血症。
Neuron. 2010 May 27;66(4):508-22. doi: 10.1016/j.neuron.2010.04.017.
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Neurosurg Clin N Am. 2010 Apr;21(2):339-52. doi: 10.1016/j.nec.2009.10.011.
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