Effect of Early Correction of Hyponatremia on Neurological Outcome in Traumatic Brain Injury Patients
Journal Title: Journal of Intensive and Critical Care - Year 2017, Vol 3, Issue 1
Abstract
Background: Hyponatremia is common in neurocritical care. If it is timely corrected, it can prevent deadly complication like brain edema and may improve overall prognosis in these patients. Methods: Retrospective analysis of 150 patients of traumatic brain injuries who developed hyponatremia during stay in intensive care unit (ICU) was performed. Neurological outcome was defined on the basis of Glasgow Coma Scale (GCS), comparing GCS on admission and GCS at the time of discharge from ICU. Good neurological outcome was defined, if GCS improved significantly as compared to admission and poor neurological outcome if GCS remained same or deteriorated than admission or patient died during ICU stay. On the basis of correction of serum sodium within 48 h of onset of hyponatremia, two groups (correction achieved or not) were compared to the neurological outcome groups, as defined earlier. Chi Square test and Multiple Logistic Regression Model were used to assess association between correction of hyponatremia within 48 h & neurological outcome. Data was analyzed by SPSS Version 21 and Stata Statistical Package 13. P value<0.05 was considered significant. Results: Majority of patients were male, 88% versus 12% of females. Mean age remained 32.7 years. In 108 patients correction of hyponatremia was achieved within 48 h and in 42 cases it took longer time to correct. Good neurological outcome was seen in 83% cases and poor outcome in 17%. Statistically significant association was seen between serum sodium correction within 48 h of onset and neurological outcome (Chi Square, P<0.0001), (Logistic Regression analysis, P<0.001 in univariate & 0.007 in multivariate analysis). Conclusion: There is significant association between early correction of hyponatremia and neurological outcome in traumatic brain injury patients.
Authors and Affiliations
Khalil Ahmad, Hesham Mohamed Elkholy, Adel Elsaid Elkhouly, Maged Mohsen Beniamein, Ammar Abdel Hadi, Sohail Majeed, Ahmad Shoaib
Keywords
Related Articles
- EP ID EP299708
- DOI 10.21767/2471-8505.100064
- Views 67
- Downloads 0
Patient early mobilization: A Malaysia's study of nursing practices
Background: The practices of early mobilization on mechanical ventilated patient is associated to decrease length of stay in intensive care unit, decrease ventilator associated pneumonia, prevent deep vein thrombosis and...
Acute and Short Term Hyperoxemia: How about Hemorheology and Tissue Perfusion?
Acute and Short Term Hyperoxemia: How about Hemorheology and Tissue Perfusion? Tissue perfusion is a major factor determining the prognosis, morbidity and mortality in ICU patients. Perfusion may carry on via uninterrupt...
With or Without ARDS: Evidence Regarding PEEP levels
Positive end-expiratory pressure (PEEP) is defined as the alveolar pressure above atmospheric pressure that exists at the end of expiration, and it comprehends the intrinsic PEEP and extrinsic PEEP [1]. Intrinsic PEEP is...
More than Expectorant: New Scientific Data on Ambroxol in the Context of the Treatment of Bronchopulmonary Diseases
Background:Ambroxol has been established for decades in the treatment of acute and chronic respiratory diseases. A reassessment of the benefit-risk was conducted recently. Objective: What new scientific data, relevant fo...
Should We Care about Driving Pressure during Assisted Mechanical Ventilation?
During passive mechanical ventilation, at absence of dynamic hyperinflation, driving pressure of respiratory system (ΔP) is defined as static end-inspiratory plateau pressure (Pplat) minus external positive end-expirator...