Hypernatremia in intensive care unit

• Published in: Journal of critical care Vol. 81; p. 154592
• Main Authors: Emgin, Omer, Eser, Mustafa, Rollas, Kazim, Cakirgoz, Mensure
• Format: Journal Article
• Language: English
• Published: Philadelphia Elsevier Inc 01.06.2024; Elsevier Limited
• Subjects: Creatinine; Critical care; Hypernatremia; Intensive care; Mortality; Hypernatremia; Intensive care; Mortality
• DOI: 10.1016/j.jcrc.2024.154592
• ISSN: 0883-9441

Hypernatremia is a common electrolyte disorder in intensive care units (ICU). Hypernatremia is an independent risk factor for mortality. There are not enough trials on the frequency and impact of mortality associated with hypernatremia in the ICU. The aim of this study is to investigate the incidence of hypernatremia, its impact on ICU length of stay (ICU-LOS), and 28-day mortality. This is a retrospective cohort study. In this study, we included the patients who were admitted to the ICU in the last three mounts of 2022. Patients younger than 18 years old and ICU-LOS shorter than 48 h were excluded. We analyzed the sodium levels on admission and the highest sodium value during ICU stay. The main outcomes of this study were ICU-LOS and 28-day mortality. A total of 150 patients were included in this study. Of them, 45 (30%) had hypernatremia. The number of patients who underwent invasive mechanical ventilation [n:44 (97.8%] and who developed acute kidney injury [n:28 (62.2%)] were higher in the hypernatremic group (respectively; p < 0.001, p = 0.003). The length of stay in ICU [19.0/day (8.0–34.5)] and 28-day mortality [n:23 (51.1%)] were higher in the hypernatremic group (respectively; p < 0.001, p = 0.014). (Table 1) The incidence of hypernatremi is high in the patient who treated in ICU and it is associated with high mortality rate. The rate of hypernatremi in this study higher than the other ICU studies. The patients who receiving IMV have a significant risk for hypernatremia. This result may be explained by the fact that awake patients who are not on IMV can more easily maintain sodium and fluid homeostasis. The patient in ICU should closely monitored for sodium and fluid treatment especially receiving IMV. Further prospective observational studies are needed on the effect of hypernatremia on clinical outcomes in ICU patients.