Two devils hypernatremia and hyponatremia can show faces to the same patient in the intensive care unit 英文参考文献.docVIP

Available online /content/13/2/404 Letter Two devils: hypernatremia and hyponatremia can show faces to the same patient in the intensive care unit Payam Eghtesadi-Araghi1, Mohammad R Rasouli2 and Majid Mokhtari3 1Parsteb Pajouheshyar Medical Sciences Research Institute, Department No. 5, 37th (Eastern), First Golzar St., Ashrafi Esfahani Blvd., Ponak Sq., Tehran 1476783476, Iran 2Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Sina Hospital, Hassan-Abad Sq, Tehran, 11365-3876, Iran 3Department of Medicine, Internal Medicine, Pulmonary and Critical Care, Shahid Beheshti University of Medical Sciences, Imam Hosein Public Hospital, Shaheed Madani St., Tehran, 1617763141, Iran Corresponding author: Payam Eghtesadi-Aragh, payam.eghtesadi@ Published: 6 March 2009 Critical Care 2009, 13:404 (doi:10.1186/cc7722) This article is online at /content/13/2/404 ? 2009 BioMed Central Ltd See related research by Stelfox et al., /content/12/6/R162 In an article by Stelfox and colleagues published in the December 2008 issue of Critical Care, the authors tried to determine the incidence of sodium disturbance (SD) and risk factors of SD during intensive care unit (ICU) admission [1]. The impact of SD on patient mortality was also evaluated. A significant hypernatremic episode and its impact on final outcome could therefore easily be missed in a final analysis of patients who experienced a transient hyponatremia as the first episode of SD or vice versa. In other words, examining the impact of SD on the final outcome of patients in the ICU should take into consideration the spectrum of SD in a given patient in the ICU rather than an episode of hyponatremia or hypernatremia in isolation. It is not clear in their paper whether the investigators examined the effects of mixed SD happening in the same patient during their ICU stay. In this large study, the pati