Urea for treatment of acute SIADH in patients with subarachnoid hemorrhage a single-center experience 英文参考文献.docVIP
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Urea for treatment of acute SIADH in patients with subarachnoid hemorrhage a single-center experience 英文参考文献
Pierrakosetal.AnnalsofIntensiveCare2012,2:13
/content/2/1/13
RESEARCH
OpenAccess
UreafortreatmentofacuteSIADHinpatients
withsubarachnoidhemorrhage:asingle-center
experience
CharalamposPierrakos1,FabioSilvioTaccone1,3*,GuyDecaux2,Jean-LouisVincent1andSergeBrimioulle1
Abstract
Background:Hyponatremiaoccurringasaresultofthesyndromeofinappropriateantidiuretichormonesecretion
(SIADH)orcerebralsaltwastingsyndromeisacommoncomplicationinpatientswithsubarachnoidhemorrhage
(SAH).TheefficacyandsafetyofureaastreatmentforSIADH-inducedhyponatremiahasnotbeenreportedinthis
population.
Methods:ThisisaretrospectiveanalysisofallpatientsadmittedtoourdepartmentfornontraumaticSAHbetween
January2003andDecember2008(n=368).AllpatientswithSIADH-inducedhyponatremia(plasma
sodium135mEq/L,urinesodium20mEq/L,andosmolality200mOsm/kg;absenceofovertdehydrationor
hypovolemia;noperipheraledemaorrenalfailure;nohistoryofadrenalorthyroiddisease)routinelyreceivedurea
peroswhenhyponatremiawasassociatedwithclinicaldeteriorationorremainedlessthan130mEq/Ldespite
salinesolutionadministration.
Results:Forty-twopatientsdevelopedSIADHandweretreatedwithurea.Ureawasstartedafteramedianof7
(IQR,5–10)daysandgivenorallyatdosesof15–30gtidorqidforamedianof5(IQR,3–7)days.Themedian
plasmasodiumincreaseoverthefirstdayoftreatmentwas3(IQR,1–6)mEq/L.Hyponatremiawascorrectedinall
patients,withmediantimestoNa+130and135mEq/Lof1(IQR,1–2)and3(IQR,2–4)days,respectively.Urea
waswelltolerated,andnoadverseeffectswerereported.
Conclusions:Oralureaisaneffectiveandwell-toleratedtreatmentforSIADH-inducedhyponatremiainSAH
patients.
Keywords:Hyponatremia,SIADH,Sodium,Subarachnoidhemorrhage,Urea
Background
worseningcerebraledemaandintracranialhypertension,
Hyponatremia, defined as a plasma sodium concentra- promoting seizures and further compromising neuro-
tionlessthan135mEq/L[1],isacommoncomplication logical recovery [4]. Thus, early diagnosis and effective
in patients with subarachnoid hemorrhage (SAH) [2,3]. treatment of hyponatr
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