医学
神经重症监护
重症监护医学
血管内容积状态
Copeptin蛋白
低钠血症
电解质紊乱
病危
内科学
血流动力学
加压素
作者
Rita Varudo,Inês Pimenta,Jacobo Bacariza Blanco,Filipe Gonzalez
出处
期刊:Case Reports
[BMJ]
日期:2022-02-01
卷期号:15 (2): e246995-e246995
被引量:3
标识
DOI:10.1136/bcr-2021-246995
摘要
Hyponatraemia is the most prevalent electrolyte disorder in the neurocritical care setting and is associated with a significant morbimortality. Cerebral salt wasting and inappropriate antidiuretic hormone secretion syndrome have been classically described as the two most frequent entities responsible for hyponatraemia in neurocritical care patients. An accurate aetiological diagnosis of hypotonic hyponatraemia requires a proper volume status assessment. Nevertheless, determination of volume status based on physical examination, laboratory findings and imaging modalities have several limitations and can lead to improperly diagnosis and hyponatraemia mismanagement. Point-of-care ultrasound (POCUS), specifically Venous Excess UltraSound (VExUS) score, is a fast and valuable tool to evaluate venous congestion at the bedside and identify hypervolaemia, helping the physicians in therapeutic decision making in a patient with hyponatraemia. We report a case where the use of POCUS, and more specifically VExUS, can be helpful in volume status assessment, complementing the complex management of multifactorial hyponatraemia in a neurocritical patient.
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