Development of hyponatremia in non-critical patients receiving total parenteral nutrition: A prospective, multicenter study.

Autor: Gómez-Hoyos E; Endocrinology and Nutrition Department, Hospital Clínico Universitario de Valladolid-IEN, Universidad de Valladolid, Valladolid, Spain. Electronic address: emiliagomezhoyos@gmail.com., Buigues AO; Endocrinology and Nutrition Department, Hospital Clínico Universitario de Valladolid-IEN, Universidad de Valladolid, Valladolid, Spain., Ballesteros Pomar MD; Endocrinology and Nutrition Department, Complejo Asistencial Universitario de León, León, Spain., Casariego AV; Endocrinology and Nutrition Department, Complejo Asistencial Universitario de León, León, Spain., Delgado YG; Endocrinology and Nutrition Department, Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain., Ocón Bretón MJ; Endocrinology and Nutrition Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain., Abad González AL; Endocrinology and Nutrition Department, Hospital General Universitario de Alicante, Alicante, Spain., Luengo Pérez LM; Endocrinology and Nutrition Department, Hospital Infanta Cristina, Badajoz, Spain., Martín PM; Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IDISSC), Madrid, Spain., Tapia Guerrero MJ; Endocrinology and Nutrition Department, Hospital Regional Universitario de Málaga, Málaga, Spain., Del Olmo García MD; Endocrinology and Nutrition Department, Hospital Universitario Severo Ochoa, Madrid, Spain., Ruiz AH; Endocrinology and Nutrition Department, Hospital Clínico Universitario de Salamanca, Salamanca, Spain., Hernández JÁ; Endocrinology and Nutrition Department, Hospital Universitario Príncipe de Asturias, Madrid, Spain., Guerrero DB; Endocrinology and Nutrition Department, Complejo Hospitalario Universitario de Ferrol, Coruña, Spain., Antolín SH; Endocrinology and Nutrition Department, Hospital Universitario de Guadarajara, Guadarajara, Spain., Tenorio-Jiménez C; Endocrinology and Nutrition Department, Complejo Hospitalario de Jaén, Jaén, Spain., García Zafra MV; Endocrinology and Nutrition Department, Hospital Universitario Santa Lucia, Cartagena, Spain., Romero FB; Endocrinology and Nutrition Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain., Pla MA; Endocrinology and Nutrition Department, Hospital Universitario y Politécnico de La Fe, Valencia, Spain., Martínez Olmos MA; Endocrinology and Nutrition Department, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain., Lemes IB; Endocrinology and Nutrition Department, Hospital Universitario Gregorio Marañón, Madrid, Spain., De la Vega IR; Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IDISSC), Madrid, Spain., De Luis Román D; Endocrinology and Nutrition Department, Hospital Clínico Universitario de Valladolid-IEN, Universidad de Valladolid, Valladolid, Spain.
Jazyk: angličtina
Zdroj: Clinical nutrition (Edinburgh, Scotland) [Clin Nutr] 2019 Dec; Vol. 38 (6), pp. 2639-2644. Date of Electronic Publication: 2018 Nov 30.
DOI: 10.1016/j.clnu.2018.11.014
Abstrakt: Background & Aims: Hyponatremia is frequent in hospitalized patients, especially in those receiving total parenteral nutrition (TPN). Furthermore, the presence of hyponatremia is associated with increased morbimortality in both groups. The goal of this study is to describe the prevalence of hyponatremia developing during TPN in non-critical patients, and identify risk factors for its appearance.
Methods: This prospective multicenter study involved 19 Spanish hospitals. Noncritically-ill patients prescribed TPN over a 9-month period were studied. Variables analyzed demographic characteristics, prior comorbidities, drug therapy, PN composition, additional iv fluids, and serum sodium levels.
Results: A total of 543 patients were recruited, 60.2% males. Age: 67 (IR 57-76). Of 466/543 who were eunatremic when starting TPN, 18% developed hyponatremia (serum sodium < 135 mmol/L) during TPN. Independent risk factors identified by logistic regression analysis: female (OR 1.74 [95% CI = 1.04-2.92], p = 0.036); severe malnutrition (OR 2.15 [95% CI = 1.16-4.35], p = 0.033); opiates (OR 1.97 [95% CI = 1.10-3.73], p = 0.036); and nausea/vomiting (OR 1.75 [95% CI = 1.04-2.94], p = 0.036).
Conclusions: Previously eunatremic patients frequently develop hyponatremia while receiving TPN. In this group, severe malnutrition is an independent risk factor for hyponatremia, as well as previously described risk factors: opiates, nausea/vomiting, and female gender.
(Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)
Databáze: MEDLINE
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