• Elisabeth A J de Vos and van der VoortPeter H JPHJDept. of Intensive Care, OLVG Hospital, Oosterpark 9, 1091 AC Amsterdam, the Netherlands; TIAS School for Business and Society, Warandelaan 2, 5037 AB Tilburg, the Netherlands; Department of Critical Care, University of Groningen,.
• Dept. of Intensive Care, OLVG Hospital, Oosterpark 9, 1091 AC Amsterdam, the Netherlands. Electronic address: e.a.j.devos@olvg.nl.
• J Crit Care. 2021 Apr 1; 62: 72-75.

PurposeICU acquired hypernatremia (IAH) is associated with increased morbidity and mortality, however treatment remains controversial. This study aims to determine the effect of enteral free water suppletion in patients with IAH.Materials And MethodsRetrospective single center study in a tertiary ICU.Inclusion Criteriapatients with IAH and treatment with enteral free water.Exclusion Criteriapatients with renal replacement therapy, diabetic ketoacidosis or hyperosmolar hyperglycaemic state.Primary Outcomechange in plasma sodium (in mmol/l) after 5 days treatment. Responders were defined as patients with a decrease in sodium level of 5 mmol/l or more.ResultsIn total 382 consecutive patients were included. The median sodium level at the start of water therapy was 149 mmol/l (IQR 147-150). The median volume of enteral water was 4423 ml (IQR 3349-5379 ml) after 5 days and mean sodium decrease was 1.87 mmol/l (SD 4.84). There was no significant correlation between the volume of enteral water and sodium decrease (r2 = 0.01).ConclusionsTreatment with enteral free water did not result in a clinically relevant decrease in serum sodium level in patients with IAH. In addition, the volume of enteral free water and the use of diuretics was unrelated with sodium change over 5 days.Copyright © 2020 Elsevier Inc. All rights reserved.

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