Catabolism highly influences ICU-acquired hypernatremia in a mainly trauma and surgical cohort

Rugg, C; Woyke, S; Ronzani, M; Levé, AM; Spraider, P; Loveys, S; Schmid, S; Kreutziger, J; Ströhle, M

doi:10.1016/j.jcrc.2023.154282

Trauma & major bleeding

Catabolism highly influences ICU-acquired hypernatremia in a mainly trauma and surgical cohort

J Crit CarePublished 27 Feb 2023Retrospective cohort study

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Authors' conclusion

Late- and prolonged-hypernatremia is highly related to an increased protein metabolism.

Study context

Population: ICU patients, mainly trauma and surgical cohort
Participants: 994 patients

Exposure: Early-, prolonged- and late-hypernatremic vs non-hypernatremic ICU patients
Non-hypernatremicn = 617reference
Early-hypernatremicn = 87
Prolonged-hypernatremicn = 169
Late-hypernatremicn = 121
Outcome: ICU-acquired hypernatremia

Methodological detailssingle-centre

Single-centre

Main finding

As reported in the abstract

Developed ICU-acquired hypernatremia

377

38%

Observational data: associations, not effects.

Further findings

Increased age, SAPS-III and signs of catabolism, but not hypernatremia itself, significant risk factors for mortality

Reference

Authors: Rugg C, Woyke S, Ronzani M, Levé AM, Spraider P, Loveys S, et al.
All 9 authors
Rugg C, Woyke S, Ronzani M, Levé AM, Spraider P, Loveys S, Schmid S, Kreutziger J, Ströhle M
Journal: Journal of Critical Care
Published: 27 Feb 2023
DOI: 10.1016/j.jcrc.2023.154282
PubMed: 36857855

Topic: Trauma & major bleeding

Exposure definitions

Early-hypernatremic: only before ICU-day 4
Prolonged-hypernatremic: before and after ICU-day 4
Late-hypernatremic: only after ICU-day 4

Key notes

Decreased eGFR and urine sodium, increased urea-to-creatinine ratio (UCR) and fraction of urea in urine osmolality, specifically in the prolonged and late groups
Decreased eGFR a risk factor for hypernatremia in all groups; disease severity and increased catabolism particularly in the prolonged and late groups

Original publication

Catabolism highly influences ICU-acquired hypernatremia in a mainly trauma and surgical cohort. J Crit Care. Published 27 February 2023. doi:10.1016/j.jcrc.2023.154282

Read the original article ↗

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