Treatment of acute hyponatremia: Ensuring the excretion of a predictable amount of electrolyte-free water
Treatment of acute hyponatremia: Ensuring the excretion of a predictable amount of electrolyte-free water
复制标题
DOI：
10.1097/00003246-200006000-00037
复制
发表时间：
2000-06-01
影响因子：
8.8
通讯作者：
Halperin, ML
中科院分区：
文献类型：
--
作者：
Porzio, P;Halberthal, M;Halperin, ML
Background: Hypertonic saline is the recommended therapy to shrink swollen brain cells in patients with acute hyponatremia accompanied by seizures.Objectives: In the absence of hypertonic saline, hypertonic mannitol will shrink the cell volume. Because mannitol is excreted rapidly, our aim was to ensure that it would be excreted with electrolyte-free water (ERW) and to evaluate the renal mechanisms responsible for ENV excretion.Design: A randomized, prospective, placebo-controlled study in rats was carried out in a research laboratory.Subjects: Adult male Wistar rats.Interventions: The control group of rats (n = 6) was administered hypotonic saline, a loop diuretic, vasopressin, and glucose by the intraperitoneal route; in the experimental group (n = 6), glucose was replaced with mannitol. Plasma electrolytes were measured at 0 and 210 mins, and balances for water, sodium, and potassium were obtained from 0 to 90 mins and from 90 to 210 mins,Measurements and Main Results: Virtually 100% of the administered mannitol was excreted within 210 mins, and half was excreted in the first 90 mins. The urine contained ENV only in the mannitol group because of a larger volume in the first 90 mins (EFW, 3.7 mt) and to a lower excretion of NaCl in the next 120 mins (EFW, 3.5 mt).Conclusions: The combined use of mannitol and a loop diuretic caused the excretion of a predictable volume of EFW because the urine was iso-osmotic to plasma and contained all the administered mannitol, The calculated decrease in intracellular fluid Volume was equivalent when mannitol was retained or excreted.
