Hypernatremia is a common electrolyte disorder affecting hospitalized patients with associated increased mortality. It is more likely to be found in intensive care patients and is frequently iatrogenic. Hypernatremia comes from either a hypertonic sodium gain or a net water loss, with a variety of etiologies, ranging from medication infusions or oral ingestion to renal mechanisms or other physiologic fluid losses. It leads to a hyperosmolality that can cause significant neurologic dysfunction by the consequent effect of fluid shifts on brain cells. Management of hypernatremia includes both addressing the mechanisms causing the electrolyte disorder and correcting the current state of hypertonicity. In assessing and treating hypernatremia, it is important to evaluate the patient’s overall fluid status as well as the chronicity of the condition, since rapid correction of hypernatremia can lead to brain edema and convulsions. Given the deleterious effects of both hypernatremia and inappropriate correction of hypernatremia, it is important to be familiar with appropriate workup and treatment.
KeywordsHypernatremia Hypertonicity Hyperosmolality Brain cell shrinkage Sodium ingestion
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