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At least 1,063 records · Page 59Linked to original sources
PubMed1998

Iatrogenic acute hyponatraemia in a college athlete.

Hyponatraemia is one of the most common electrolyte abnormalities, leading to significant morbidity and mortality. In the most basic sense, hyponatraemia can be due to sodium loss or fluid excess. The extracellular fluid status is used to clinically divide hyponatraemia into three categories to help to determine both the cause and treatment required. Hyponatraemic patients can be categorised on the basis of their fluid status as hypovolaemic, euvolaemic, or hypervolaemic. Another distinction to make in evaluating hyponatraemia is whether the onset was acute or chronic in nature. The case presented here is iatrogenic acute hypervolaemic hyponatraemia in a college athlete. The patient presented in respiratory distress with an altered mental status after the administration of hypotonic fluids for treatment of muscle cramps. Treatment included intubation, water restriction, and furosemide, to which he responded favourably. Hyponatraemia should be in the differential diagnosis for patients presenting after intravenous fluid administration.

Acute Disease↗
PubMed1981

Iatrogenic hyponatraemia of the newborn due to maternal fluid overload: a prospective study.

Over five weeks 136 out of 246 deliveries were studied. Maternal plasma sodium concentrations were normal at admission. At delivery no significant difference was found between maternal and infant cord plasma sodium concentrations. Twenty-four of the 41 mothers who had received only oral fluids during labour had infants whose cord plasma sodium concentrations were normal. Of the 95 mothers who had been given intravenous fluids, however, only 14 infants with normal plasma sodium concentrations, 31 had a concentrations of 130 mmol (mEq)/1 or less and nine of these had a concentration of 125 mmol/1 or less. There was a highly significant inverse relation between cord plasma sodium concentration and rate of fluid administration, suggesting that hyponatraemia was due to intravenous treatment with predominantly sodium-free solutions. Endogenous antidiuretic activity probably increases during labour, and synthetic oxytocin in large doses has been shown to have an antidiuretic effect. The dose used in this study did not appear to have such an effect. Glucose solutions are often used as a vehicle for oxytocin; 83% of all fluid intake in this study was 5% or 10% glucose in water. Fluid balance in labour should be supervised closely, and oxytocin should be given in a more concentrated solution.

Birth Weight↗
PubMed2004

Urinary excretion half life of trichloroacetic acid as a biomarker of exposure to chlorinated drinking water disinfection by-products.

AIMS: To measure accurately urinary elimination half life of trichloroacetic acid (TCAA). METHODS: A longitudinal pilot exposure/intervention study measured the elimination half life of TCAA in urine. Beverage consumption was limited to a public water supply and bottled water of known TCAA concentration, and ingestion volume was managed. The five participants limited fluid consumption to only the water provided. Consumption journals were kept by each participant and their daily first morning urine (FMU) samples were analysed for TCAA and creatinine. TCAA elimination half life curves were generated from a two week washout period using TCAA-free bottled water. RESULTS: Individual elimination half lives ranged from 2.1 to 6.3 days, for single compartment exponential decay, the model which fit the data. CONCLUSION: Urinary TCAA is persistent enough to be viable as a biomarker of medium term (days) exposure to drinking water TCAA ingestion within a range of realistic concentrations.

Adult↗
PubMed1997

Visual disturbances and transurethral resection of the prostate: the TURP syndrome.

A 73-year-old man with a history of a cerebral and a cardiac vascular disease and atrial flutter developed visual disturbances characterized by vision being dark in both eyes and by seeing as through a color photographic negative immediately after an uncomplicated transurethral resection of the prostate (TURP) for prostatic hyperplasia under spinal anesthesia. There was complete remission of the symptomatology after 2.5 h. A cerebrovascular workup was negative. Considering postoperative hyponatremia and hypoosmality, we discuss the possible role of glycine-induced visual disturbances as described in the TURP reaction syndrome, to our knowledge an entity almost unknown in the neurologic literature. Glycine-induced visual disturbances should therefore be considered in the differential diagnosis of bilateral transient visual loss.

Aged↗
PubMed1985

Acute brain edema due to water loading in a young woman.

Increased intracranial pressure developed in a mentally and physically normal patient following ingestion of 30 glasses of water as a voluntary preparation for ultrasonic gynecological examination. Hyponatremia resulted and induced brain edema which provoked increased intracranial pressure. Hyponatremia was treated by intravenous infusion of hypertonic NaCl and mannitol solutions. Corticosteroids were added and continued for a week. The patient totally recovered 4 days after admission.

Acute Disease↗