Sodium Disturbances in Neurocritically Ill patients.

Abstract

Disorders of sodium and water homeostasis are common in critically ill neurologic patients. A high index of suspicion should therefore be maintained in this patient group. Proper management necessitates an accurate diagnosis of the type of dysnatremia. The study illustrates common and important treatment problems in the dysnatraemic patients. The optimal treatment of hyponatremia is controversial, but appropriate treatment must be determined according to the osmolality and volume status of the patient. If left untreated, serious CNS complications and adverse outcomes, including an increased risk of death, can occur. Asymptomatic patients can be managed successfully with a logical approach to diagnosis and a period of close monitoring. Treatment should be restricted to acute symptomatic patients in whom the associated mortality is significantly higher than the normal population.