Management of sodium imbalance in neurosurgical patients

ABSTRACT

The present study was undertaken to find the incidence of various sodium [Na] anomalies their management and outcome in the neuro surgical intensive care unit [NICU]of Khoula hospital. A total of 50 patients were followed up for serum Na of 50 patients were grouped as syndrome of inappropriate ADH secretion [SIADH] cerebral salt wasting [CSW] and diabetes inspidus [DI], according to strict diagnostic criteria. Twenty seven patients [54%] had Na anomalies. Of the 14 hyponatremic patients, 7 were CSW, 3 were SIADH and 4 were SIADH who later become CSW. Of the 13 hypernatremic patients, 2 were dehydration, 3 were DI and in 8 cases, who died, hypermatremia was seen as a terminal event. In view of the high incidence of Na imbalance in neuro patients, strict diagnostic criteria and treatment flow charts need to be followed