2014欧洲低钠血症诊疗指南答案.pptVIP

 2014 欧洲低钠血症诊疗指南解读;欧洲危重病学会（ESICM）， 欧洲内分泌学会（ESE） 欧洲肾脏最佳临床实践（European Renal Best Practice ERBP)为代表的欧洲肾脏病协会和欧洲透析与移植协会（ERA-EDTA）共同制定了欧洲低钠血症临床诊疗指南 ;低钠血症;6. 低钠血症诊断Diagnosis of hyponatraemia6.1. 分类：Classification of hyponatraemia;依据发生时间分类： 6121： 急性低钠血症48h 6122: 慢性低钠血症≥48h 6123 如果不能对其分类，除非有临床或回顾性反证（表8），则应认为系慢性低钠血症;;低钠血症分类的说明;6.2 证实低渗性排除非低渗性低钠血症;6.3 区别低渗性低钠血症的参数？;关于区别低渗性低钠血症的参数的建议 （G22）;低钠血症;低渗性低钠血症的治疗;症状严重程度？;7.1.1:严重低钠血症患者（慢或急性）第1小时处理First-hour management, regardless of whether hyponatraemia is acute or chronic; 7.1.2：1小时后血钠 5 mmol/L,症状改善的接续治疗;7.1.3：1小时后，血钠 5mmol/l，但症状无改善;7.2. 中重度低钠血症（Hyponatraemia with moderately severe symptoms）;7.3 无中重度症状的急性低钠血症（Acute hyponatraemia without severe ormoderately severe symptoms）; 7.4 ：无中重度症状的慢性低钠血症： ;7.4.2:高血容量低钠血症  Patients with expanded extracellular fluid;7.4.4:低血容量的低钠血症 ;对于临床实践的建议;7.5:如低钠血症被过快纠正需注意什么？;For demeclocycline and lithium, there is some evidence of possible harm, so we advise against their use for management of any degree of chronic hyponatraemia in patients with SIAD. Although vasopressin receptor antagonists do increase serum sodium, the guideline development group judged that based on current evidence, these drugs cannot be recommended. ;Indeed, the risk benefit ratio seems to be negative: there is no proven outcome benefit aside from increase in serum sodium concentrations, while there are increasing concerns on safety. The most prominent safety related factor is the increased risk for overly rapid correction of hyponatraemia As this risk is greatest in patients with profound hyponatraemia, the guideline development group wanted to recommend against the use of vasopressin receptor antagonists in this specific patient group.;谢谢