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Topic: Hypernatremia

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	Hypernatremia Information on Healthline
		Hypernatremia does not occur in diabetes insipidus if the patient is able to drink enough water to keep up with urinary loss, which may be as high as 10 liters per day.
		Hypernatremia can also occur accidentally in the hospital when patients are infused with solutions containing sodium, such as sodium bicarbonate for the treatment of acidosis (acidic blood).
		Hypernatremia is diagnosed by acquiring a blood sample, preparing plasma, and using a sodium-sensitive electrode for measuring the concentration of sodium ions.
	www.healthline.com /galecontent/hypernatremia (770 words)

	Hypernatremia
		Hypernatremia is treated with infusions of a solution of water containing 0.9% sodium chloride (0.9 grams NaCl/100 ml water), which is the normal concentration of sodium chloride in the blood plasma.
		In emergencies, such as when hypernatremia is causing neurological symptoms, infusions may be conducted with salt solutions containing 0.45% sodium chloride, which is half the normal physiologic level.
		Hypernatremia occurs only in unusual circumstances that are not normally under a person's control.
	www.healthatoz.com /healthatoz/Atoz/ency/hypernatremia.jsp (918 words)

	Hypernatremia \| aHealthyAdvantage (Site not responding. Last check: )
		Hypernatremia does not occur in diabetes insipidus if the patient is able to drink enough water to keep up with urinary loss, which may be as high as 10 liters per day.
		Hypernatremia is diagnosed by acquiring a blood sample, preparing plasma, and using a sodium-sensitive electrode for measuring the concentration of sodium ions.
		Hypernatremia is treated with infusions of a solution of water containing 0.9% sodium chloride (0.9 grams NaCl/100 ml water), which is the normal concentration of sodium chloride in the blood plasma.
	www.ahealthyadvantage.com /topic/topic100586971 (1063 words)

	Fluids and Electrolytes - Sodium Imbalance
		Hypernatremia is usually caused by water loss from the gastrointestinal, respiratory, or from the Kidneys.
		Hypernatremia initially causes fluid to be pulled from the cells of the brain resulting in shrinkage.
		This is the primary cause of the neurological symptoms associated with hypernatremia.
	rnbob.tripod.com /sodiumimbalance.htm (924 words)

	American Family Physician: Hypernatremia in the elderly
		The prognosis of hypernatremia in elderly patients depends on the severity of underlying disease, prompt recognition of hypernatremia and rapid initiation of proper therapy.
		Hypernatremia may also develop in situations that mandate infusion of a sodium-containing solution, such as in cardiac arrest, drug overdose and acidosis.
		When hypernatremia is caused by losses of both sodium and water (with the water loss in excess of sodium loss) and circulatory collapse is present, volume expanders and even isotonic saline may be necessary initially.
	www.findarticles.com /p/articles/mi_m3225/is_n1_v40/ai_7766919 (1062 words)

	Indian Pediatrics - Editorial
		Hypernatremia associated with elevated breast milk sodium is a rare cause of neonatal hypernatremia(1-3).
		Hypernatremia was associated with elevated urine specific gravity, urinary sodium, deranged renal functions and elevated breast milk sodium.
		Hypernatremia is managed with gradual correction over 48-72 hours by calculation of free water deficit and level of dehydra-tion(10).
	www.indianpediatrics.net /feb2002/feb-193-196.htm (1174 words)

	Postgraduate Medicine: Hyponatremia and hypernatremia
		Hypernatremia results from water loss or sodium retention, although sodium retention occurs in only a few circumstances (eg, administration of hypertonic sodium bicarbonate during cardiopulmonary resuscitation).
		Hypernatremia is almost never found in an alert patient who has access to water and a normal thirst mechanism.
		In adults, hypernatremia is more common after age 60, primarily because increased age is associated with decreased osmotic stimulation of thirst and decreased maximal urinary concentration.
	www.postgradmed.com /issues/2000/05_00/fall.htm (2938 words)

	NDI Abstract of Article: 160 (Site not responding. Last check: )
		Hyponatremia and hypernatremia are common electrolyte disorders resulting from disorders in water homeostasis.
		Hypernatremia results from impaired water ingestion, although increased water losses are often contributory.
		Hypernatremia is also associated with high morbidity and mortality, both as a result of the underlying disease and inadequate treatment.
	www.ndif.org /Abstract/jab-160.html (186 words)

	MEDSTUDENTS-SURGERY
		Less commonly, hypernatremia is due to hypertonic salt administration (eg, accidental intravascular injection of hypertonic saline used for induction of abortion or use of large doses of sodium bicarbonate therapy during cardiac arrest).
		Hypernatremia is the only state in which dry and sticky mucous membranes are characteristic.
		Hypernatremia due to an osmotic urea diuresis can occur if large amounts of protein and amino acids are administered by nasogastric tube, or if tissue catabolism is great, as in burns.
	www.medstudents.com.br /cirur/cirur2.htm (1179 words)

	THE MERCK MANUAL, Sec. 2, Ch. 12, Water, Electrolyte, Mineral, And Acid-Base Metabolism
		Hypernatremia is less common than hyponatremia, occurring in < 1% of hospitalized patients in an acute care hospital; however, hypernatremia in the adult patient is among the most serious electrolyte disorders, with a reported mortality of 40 to 60%.
		Hypernatremia in the elderly is particularly common in postoperative patients and in those receiving tube feedings, parenteral nutrition, or other hypertonic solutions.
		Mortality of hypernatremia in general remains high because of effects of CNS hyperosmolality and the severity of underlying illness necessary to result in inability to respond to thirst.
	www.merck.com /mrkshared/mmanual/section2/chapter12/12b.jsp (7520 words)

	HDCN: Review of abstract by Ayus et al. Metabolic consequences of hypernatremia in rats (1996 ASN Meeting) (Site not responding. Last check: )
		Hypernatremia is associated with substantial mortality in hospitalized patients.
		Although the development of hypernatremia before hospital admission occurs primarily in geriatric patients, hospital-acquired hypernatremia occurs in an age distribution similar to that of the general hospitalized population.
		Hospital-acquired hypernatremia is primarily iatrogenic, resulting from inadequate and inappropriate prescription of fluids to patients with increased water losses and impaired thirst or restricted free water intake.
	www.hdcn.com /a6/6asn0508.htm (287 words)

	Even Water Can Be Dangerous - WMSHP.net News Archives
		Hypernatremia, defined as a serum sodium concentration greater than 145 mEq/L, is a serious electrolyte disorder and is associated with significant mortality in the hospitalized patient.
		The treatment of hypernatremia can be especially difficult in patients with co-mordid conditions that appear to limit therapeutic options.
		It is important that practitioners recognize that the appropriate treatment of hypernatremia generally consists of infusions that contain some sodium.
	www.wmshp.net /archives/000043.shtml (623 words)

	Critical Care Medicine Tutorials- Hyernatremia
		Hypernatremia can be associated with significant neurologic sequelae: initially the brain shrinks due to volume depletion (this is, after all the mechanism by which we control intracranial pressure), which makes the blood vessels vulnerable to rupture.
		The rate of correction depend on the duration of hypernatremia: in general, for ICU patients, correction at a rate of 1 mmol Na/litre /hour is appropriate; if hypernatremia is prolonged, the 0.5 mmol Na/litre/hour is more advisable (to reduce the risk of rebound cerebral edema).
		Clearly, for simple hypernatremia, the choice of fluid determines the volume required to correct the sodium abnormality (a much larger volume of LR is required compared with D5%).
	www.ccmtutorials.com /problems/explore/name/hypernatremia.htm (781 words)

	THE MERCK MANUAL--SECOND HOME EDITION, Sodium in Ch. 155, Minerals and Electrolytes
		In hypernatremia, the level of sodium in the blood is too high.
		Hypernatremia occurs in people who drink too little water and in those who have diarrhea, vomiting, fever, excessive sweating (particularly during hot weather), or abnormal kidney function.
		Hypernatremia is most common among older people, who tend to sense thirst more gradually and less intensely than younger people do.
	www.merck.com /mrkshared/mmanual_home2/sec12/ch155/ch155k.jsp (1343 words)

	UpToDate Causes of hypernatremia
		— Hypernatremia is a relatively common problem that can be produced either by the administration of hypertonic sodium solutions or, in almost all cases, by the loss of free water [1,2].
		It should be emphasized that persistent hypernatremia does not occur in normal subjects, because the ensuing rise in plasma tonicity stimulates both the release of antidiuretic hormone (ADH; thereby minimizing further water loss) and, more importantly, thirst [1-3].
		This topic will review the causes of hypernatremia (show table 1); many of the individual disorders are discussed in detail separately, as are issues in diagnosis and treatment.
	patients.uptodate.com /topic.asp?file=fldlytes/7438&title=Posterior+%28Central+diabetes+insipidus%29+Pituitary+insufficiency (535 words)

	eMedicine - Hypernatremia : Article by Trung Q Pham
		Hypernatremia is an electrolyte problem that is not uncommon, especially in elderly people who are hospitalized.
		Because thirst is a potent mechanism in the response to hyperosmolality, hypernatremia patients either have an inadequate thirst mechanism or have an inability to respond to thirst.
		Chronic hypernatremia should be corrected at a rate not to exceed 0.5 mmol/L/h or a total of 10 mmol/d (eg, 160 mEq/L to 150 mEq/L in 24 h).
	www.emedicine.com /med/topic1089.htm (2329 words)

	UpToDate Diagnosis of hypernatremia
		With urinary or diarrheal losses, the degree of free water loss (and therefore the tendency toward hypernatremia) is determined by the ratio of sodium plus potassium concentration in the fluid lost to that in the plasma.
		The major protection against the development of hypernatremia is increased water intake, as the initial rise in the plasma sodium concentration stimulates thirst via the hypothalamic osmoreceptors.
		Thus, hypernatremia usually occurs in infants or in adults (particularly the elderly) with impaired mental status who may have an intact thirst mechanism but are unable to ask for water [7].
	patients.uptodate.com /topic.asp?file=fldlytes/10324&title=Posterior+%28Central+diabetes+insipidus%29+Pituitary+insufficiency (583 words)

	fpn0600
		Eighty-nine percent of patients who developed hypernatremia during hospitalization had urine concentrating defects, primarily as the result of the use of diuretics or of solute diuresis, whereas only 50% of patients who were hypernatremic on admission could be shown to have concentrating defects.
		Hypernatremia was estimated to contribute to mortality in 16%.
		The authors conclude that hospital-acquired hypernatremia is primarily iatrogenic resulting from inadequate and inappropriate restriction of fluids to patients with predictably increased water losses and impaired thirst or restricted free water intake or both.
	www.hsc.stonybrook.edu /som/fammed/newsletters/fpn0600.htm (4106 words)

	eMedicine - Hypernatremia : Article by Steven L Stephanides
		Either the osmotic load of the increased sodium acts to extract water from the cells or a portion of the burden of the body's free water deficit is borne by the cell.
		Hypernatremia is due to too little water, too much salt, or a combination thereof.
		Hypernatremia of more than 2 days' duration is considered chronic hypernatremia and is associated with an increased mortality rate.
	www.emedicine.com /emerg/topic263.htm (3320 words)

	RN S 7 fluid_electr
		Hypernatremia occurs when the serum sodium level is greater than 145 mEq/L. Hypernatremia can be caused by either a gain of sodium in excess of water or by a loss of water in excess of sodium.
		The clinical manifestations of hypernatremia are primarily neurologic and are caused by cellular dehydration.
		Decreased ECF volumes during hypernatremia cause increased pulse rates, decreased blood pressure with pronounced postural hypotension, and the pulse pressure is greatly diminished.
	www.krcintranet.com /s1321.htm (3450 words)

	Pediatrics in Review -- Rapid Responses for Waseem et al., 25 (11) 397-403
		Hypernatremia, a frequently encountered electrolyte disorder, is defined as a serum sodium level greater than 145 mmol/L and represents a deficit of water in relation to total body sodium.
		Hypernatremic dehydration may be caused by pure water loss (diabetes insipidus), hypotonic fluid loss (vomiting or diarrhea), or hypertonic sodium gain (hypertonic feeding preparations such as improperly prepared infant formula) [1].
		Forty cases of hypernatremia secondary to breast milk failure have been described in the medical literature [3].
	pedsinreview.aappublications.org /cgi/eletters/25/11/397 (2642 words)

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