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Intensive care medicine · Jan 2008
Hyponatremia in neurological patients: cerebral salt wasting versus inappropriate antidiuretic hormone secretion.
- Serge Brimioulle, Carlos Orellana-Jimenez, Adel Aminian, and Jean-Louis Vincent.
- Department of Intensive Care, Erasme University Hospital, Free University of Brussels, Lennik Road 808, 1070 Brussels, Belgium. serge.brimioulle@ulb.ac.be
- Intensive Care Med. 2008 Jan 1;34(1):125-31.
ObjectiveTo assess whether hyponatremia in acute neurological patients is associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) or with the cerebral salt-wasting syndrome (CSWS).DesignClinical, controlled, prospective study.SettingDepartment of intensive care of a tertiary care academic hospital.PatientsForty acute neurological patients with hyponatremia suggesting SIADH or CSWS (20) or with normonatremia (20).InterventionsNone.Measurements And Main ResultsMeasurement of clinical and biological variables. Measurement of blood, plasma, and red blood cell volumes to discriminate SIADH and CSWS. Renal, adrenal and thyroid functions were normal in all patients. Average blood, plasma, and red blood cell volumes were 54, 37 and 17ml/kg in control patients and 54, 37 and 18ml/kg in hyponatremic patients, respectively.ConclusionsThe adequate blood volumes in hyponatremic patients confirm the diagnosis of SIADH and do not support the concept of CSWS.
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