Table 2 Acute dysnatremias and mortality sorted by increasing serum-sodium
From: Acute Dysnatremias - a dangerous and overlooked clinical problem
Patient | Sex | Age | Serum-sodium (mmol/l) at hospital arrival | Duration of symptoms at arrival | Cause | Neurological signs/symptoms | Treatment given | Correction of s-sodium first 24 h | Time to death |
|---|---|---|---|---|---|---|---|---|---|
1 | Female | 27 | 106 | 30 min. | Over hydration and gastroenteritis last 14 h. | Coma, seizures. | Hypertonic NaCl and furosemide. | 21 mmol/l during 7 h. | Declared brain dead 16 h after arrival. |
2 | Male | 18 | 121, falling to 115 before transfer to ICU. | 6 h. | Water intoxication estimated to 20 L in 6 h. | Nausea, headache, confusion, decreased consciousness. | NaCl 9 mg/ml and mannitol. | 30 mmol/l during 12 h. | Derived diabetes insipidus, sepsis and DIC, died within few days. |
3 | Female | 20 | 123 | 1–2 h. | Over hydration before urinary sample, estimated to 10 L within 2–3 h. | Headache, dizziness, seizures, decreased consciousness. | NaCl 9 mg/ml and furosemide. | 21 mmol/l during 18 h. | 2 days. |
4 | Female | 47 | 127 | 2 h and 45 min. | Exercise-associated hyponatremia. | Headache, vomiting, decreased consciousness (GCS 7). | NaCl 9 mg/ml and 3%, also mannitol and furosemide. | 16 mmol/l during 4 h. | 19 h after onset of symptoms. |
5 | Male | 41 | 209 | 4 h. | Salt intoxication, drank mouthwash. | Status epilepticus, coma (GCS 3). | Glucose 50 mg/ml, NaCl 4,5 mg/ml and NaCl 9 mg/ml | 18 mmol/l during 13 h, 27 mmol/l during 29 h. | 72 h after intoxication. |
6 | Female | 36 | 246 | < 24 h. | Salt intoxication during excorcism. | Coma. | NaCl 9 mg/ml, glucose 50 mg/ml and furosemide. | 53 mmol/l during 7 h. | Clinically brain dead 5 h after arrival. |