Patterns of treatment and correction of hyponatremia in intensive care unit patients

Abstract

Purpose: The goal of this study was to examine the real-world patterns of care and interventions among intensive care unit (ICU) patients with hypervolemic and euvolemic hyponatremia using a large clinical database.

Materials and methods: The Phillips eICU Research Institute database was used to investigate hyponatremia treatment patterns and trends, mortality, and ICU and hospital length of stay. Demographics, clinical characteristics, and outcome variables were compared in patients corrected for hyponatremia using both a more strict and a less strict definition.

Results: At admission, 35%, 55%, and 10% of patients had mild, moderate, and severe hyponatremia, respectively. At the end of an ICU stay, the percentage of patients who did not have corrected serum sodium concentration was 48% (using a more strict definition) and 24% (using a less strict definition). Using either definition of correction, patients with serum sodium correction had lower mortality and longer survival than did patients without corrected serum sodium concentration.

Conclusions: A significant proportion of hyponatremia is not corrected during an ICU stay. Critically ill patients with hyponatremia who have their serum sodium corrected have lower mortality and longer survival, highlighting the need for more attention to hyponatremia and its correction in critically ill patients.

Keywords: Critically ill; Euvolemic; Hypervolemic; Hyponatremia; ICU; Serum sodium correction.