title: [Hypernatremia in head-injured patients: friend or foe?].
abstract: Hypernatremia is defined by a serum sodium concentration of more than 145 mmol/L and reflects a disturbance of the regulation between water and sodium. The high incidence of hypernatremia in patients with severe brain injury is due various causes including poor thirst, diabetes insipidus, iatrogenic sodium administration, and primary hyperaldosteronism. Hypernatremia in the intensive care unit is independently associated with increased mortality and complications rates. Because of the rapid brain adaptation to extracellular hypertonicity, sustained hypernatremia exposes the patient to an exacerbation of brain edema during attempt to normalize natremia. Like serum glucose, serum sodium concentration must be tightly monitored in the intensive care unit.
authors: Pôle d'anesthésie-réanimation, hôpital Michallon, BP 217, 38043 Grenoble cedex 09, France; Université Joseph-Fourier, 38042 Grenoble, France. Electronic address: jfpayen@ujf-grenoble.fr.
authors: J-F
authors: JF
authors: Payen
authors: Pôle d'anesthésie-réanimation, hôpital Michallon, BP 217, 38043 Grenoble cedex 09, France; Université Joseph-Fourier, 38042 Grenoble, France.
authors: P
authors: P
authors: Bouzat
authors: Pôle d'anesthésie-réanimation, hôpital Michallon, BP 217, 38043 Grenoble cedex 09, France; Université Joseph-Fourier, 38042 Grenoble, France.
authors: G
authors: G
authors: Francony
authors: Service d'anesthésie-réanimation, hôpital Saint-Roch, 06000 Nice, France.
authors: C
authors: C
authors: Ichai
mesh_terms: D006259:Craniocerebral Trauma / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D003422:Critical Care; D006801:Humans; D006955:Hypernatremia / Q000378:metabolism / Q000503:physiopathology*; D019586:Intracranial Hypertension / Q000503:physiopathology; D008991:Monitoring, Physiologic; D012964:Sodium / Q000097:blood
chemical_list: D012964:Sodium
keywords: Cérébrolésé; Head injury; Hypernatremia; Hypernatrémie; Intensive care; Natrémie; Osmotherapy; Osmothérapie; Réanimation; Serum sodium concentration