A Clinical study of Hyponatremia and Its Prognostic Outcome in Critically Ill Patients admitted in Intensive Medical Care Unit at Government Mohan Kumaramangalam Medical College, Salem

Deviga, G (2020) A Clinical study of Hyponatremia and Its Prognostic Outcome in Critically Ill Patients admitted in Intensive Medical Care Unit at Government Mohan Kumaramangalam Medical College, Salem. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.

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Abstract

BACKGROUND: Hyponatremia is the one of the most common electrolyte disorder in critically ill patients and is a leading cause of morbidity and mortality. This study was done to evaluate the clinical features, etiology, clinical features, severity and prognostic outcome of hyponatremia in critically ill patients admitted to Medical Intensive Care Unit. AIMS AND OBJECTIVES: 1. To ascertain frequency, predisposing conditions, clinical features, and prognostic outcome of hyponatremia in critically ill patients. 2. To study about the clinical presentation of hyponatremia. 3. To classify the severity of hyponatremia. 4. To determine its prognostic outcome –morbidity and mortality. METHODOLOGY: The present one year cross sectional observational study was done in the Department of Medicine Government Mohan Kumaramangalam medical college and hospital. A total of 100 patients admitted in MICU with hyponatraemia from February 2018 to June 2019 were studied. These patients were evaluated for identifying the cause of hyponatremia which includes clinical history, detailed clinical examination which was followed by needed laboratory investigations. All these patients were followed up till correction of hyponatremia and discharge from hospital premises. RESULTS: In our study of 100 patients admitted with hyponatremia in critical care unit slight male preponderance (52%) was noted and females were 48%. The male to female ratio was 1.36:1.Most of the patients were in the age group between 61 to 70 years (31%) followed by 71 to 80 yrs (21%). The commonest presentation was nausea and vomiting (29%) followed by confusion (25%), seizures (14%). Nearly half of the study population had altered sensorium (49%). The commonest system to be involved was central nervous system. Based on the volume status, 55% of patients were had euvolemic hyponatremia, 25% patients had hypovolemic hyponatremia and 20% patients had hypervolemic hyponatremia. 33% of the patients had severe hyponatraemia with confusion being significantly high in such patients. There was a statistically significantly association was found in cause and type of hyponatremia. The commonest cause of hyponatremia was SIADH identified in nearly half of patients with infections (Tuberculosis and pneumonia) were the predominant cause. Majority (89%) of the patients in the study were improved well. There was positive association between SIADH and euvolemic hypoosmolar hyponatremia (p<0.001) and high urine sodium (p<0.001). Most of the patients with severe hyponatremia required prolonged duration of ICU stay and ventilator requirement. CONCLUSION: Treating clinicians always need to be aware about the common occurrence of hyponatremia, its early identification and its association with mulititude of diseases. Patients presenting with hyponatraemia should be meticulously screened for the etiology. A proper understanding of the clinical features, pathophysiological process, severity of hyponatremia and its associated risk factor is necessary in prompt management of hyponatremia.

Item Type: Thesis (Masters)
Additional Information: 201711403
Uncontrolled Keywords: Hyponatraemia, Severe hyponatraemia, Serum sodium.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 28 Jan 2021 18:45
Last Modified: 31 Jan 2021 02:14
URI: http://repository-tnmgrmu.ac.in/id/eprint/13336

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