title: Comfort and incidence of abnormal serum sodium, BUN, creatinine and osmolality in dehydration of terminal illness.
abstract: This prospective clinical study was undertaken to evaluate the effect of spontaneous food/fluid intake on serum sodium and comfort levels in a population of terminal patients (n = 31) receiving clysis or intravenous hydration. The median and mode of serum sodium were within normal limits and 56 percent of the patients were eunatremic. There was no statistically significant difference in comfort scores between predehydration and dehydration phases, and 85 percent had an optimal comfort score. A statistically significant difference was found (p < 0.5) between mean daily comfort scores of those with normal sodium versus those with abnormal sodium; those with hypernatremia were lower but still in the top third comfort levels. Because the sodium was tested using a Chem7, we also were able to calculate the BUN, creatinine, and osmolality. These are presented and compared to other study results. The findings of this study reinforce the belief that fluid depletion in dying patients results in relatively benign symptoms, that serum sodium levels are not always altered with limited intake and that comfort levels can be maintained when the serum sodium is abnormal.
authors.affiliation: Fresenius Medical Care, Lexington, Massachusetts, USA.
authors.forename: K
authors.initials: K
authors.lastname: Vullo-Navich
authors.forename: S
authors.initials: S
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Andrews
authors.forename: A M
authors.initials: AM
authors.lastname: Levine
authors.forename: J F
authors.initials: JF
authors.lastname: Tischler
authors.forename: J M
authors.initials: JM
authors.lastname: Veglia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood*; D003681:Dehydration / Q000097:blood* / Q000150:complications / Q000628:therapy; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010146:Pain / Q000209:etiology*; D011446:Prospective Studies; D012964:Sodium / Q000097:blood*; D013727:Terminal Care
chemical_list: D012964:Sodium; D003404:Creatinine