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.
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.
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。
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