Urea for treatment of acute SIADH in patients with subarachnoid hemorrhage a single-center experience 英文参考文献.docVIP

Urea for treatment of acute SIADH in patients with subarachnoid hemorrhage a single-center experience 英文参考文献.doc

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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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