Evaluation and Management of Hyponatremia in the Elderly:老年患者低钠血症的评估和管理.ppt,Hyponatremia Debra Bynum,MD Division of Geriatric Medicine Clinical Case An 82 y/o woman is admitted from a nursing home with confusion. She has had a poor appetit
It is classified by volemic status into hypovolemic, euvolemic, and hypervolemic hyponatremia. Clinical history, physical examination, and blood and urine tests are important for a correct classification and diagnosis of hyponatremia, to assure correct management. Treatment of hyponatremia in cancer ...
Hypovolemic hyponatremia Isotonic saline Isotonic saline or balanced solution at 0.5-1.0 mL/kg/h Euvolemic hyponatremia (SIADH) Fluid restriction of 500 mL/d below the 24-h urine volume (first-line treatment) Urea, vaptan, or demeclocycline (second-line treatment) Fluid restriction (first-line...
aPatients who are hypovolemic and have inadequate preload can have low CI and a high SVR mimicking CS. Patients should show adequate filling pressures and be resuscitated as needed before proceeding with CS diagnosis. bNitroglycerin provides more venous than arterial vasodilation and often is used ...
Main interventions include correction for hypovolemic shock, effective control of bleeding, prevention of bleeding-related complications (such as infection, electrolyte and acid-base imbalance, and HE), maintenance of airway patency, oxygen inhalation, and monitoring of vital signs and urine output. In...
The management of hypovolemic hyponatremia is essentially based upon the administration of sodium with the aim of normalizing the depleted body sodium stores, while the key to management of hypervolemic hyponatremia is to increase renal solute-free water excretion.The other electrolyte disorders that ...
Atypical presentation of COVID-19 in an older adult: Lethargy and vomiting from severe hypovolemic hyponatremia The coronavirus disease 2019 (COVID-19) pandemic disproportionately affects older adults, who suffer from more severe infections and higher mortality rates... LY Tee,B Yap,GK Sidhu,.....
The optimization of right-sided filling pressures is crucial in the management of RVF as both hypovolemic and hypervolemic states have deleterious effects leading to decreased CO. In hypovolemic patients, fluid loading produces a 30 % mean increase in right ventricular end-diastolic volume index ...
of complications including hyponatremia, a variable degree of hypo-osmolality, and certain solution-specific problems that are described below. Isotonic electrolyte-containing solutions cannot be used with monopolar energy because this leads to activation of ions that disperse the electric current and ...
Regarding the definition of hypoalbuminemia, usually a cut-off of 30 g/L is used. However, there is significant variation between serum albumin assays in different laboratories. The 2021 KDIGO guideline states: “Laboratory-specific values: serum albumin should be measured by bromocresol purple (...