Intravenous infusion of glucose 5% despite sodium mixed, is main contributor of acquired hyponatremia in adult polyvalent medicine service: Case control study.

Autor: Mackanga JR; Department of Internal medicine and medical specialties, University of Health sciences of Libreville, Allée de Compiègne 3rd floor, apartment 13, 37000 Tours, France. Electronic address: jrmackanga@gmail.com., Dibambou N; Department of Internal medicine and medical specialties, University of Health sciences of Libreville, Allée de Compiègne 3rd floor, apartment 13, 37000 Tours, France., Mouloungui EM; Department of Internal medicine and medical specialties, University of Health sciences of Libreville, Allée de Compiègne 3rd floor, apartment 13, 37000 Tours, France., Iba-Ba J; Department of Internal medicine and medical specialties, University of Health sciences of Libreville, Allée de Compiègne 3rd floor, apartment 13, 37000 Tours, France., Kombila UD; Department of Internal medicine and medical specialties, University of Health sciences of Libreville, Allée de Compiègne 3rd floor, apartment 13, 37000 Tours, France., Bignoumba PI; Department of Internal medicine and medical specialties, University of Health sciences of Libreville, Allée de Compiègne 3rd floor, apartment 13, 37000 Tours, France., Moussavou IM; Department of Internal medicine and medical specialties, University of Health sciences of Libreville, Allée de Compiègne 3rd floor, apartment 13, 37000 Tours, France., Missounga L; Department of Internal medicine and medical specialties, University of Health sciences of Libreville, Allée de Compiègne 3rd floor, apartment 13, 37000 Tours, France., Kombila JM; Department of Internal medicine and medical specialties, University of Health sciences of Libreville, Allée de Compiègne 3rd floor, apartment 13, 37000 Tours, France., Boguikouma JB; Department of Internal medicine and medical specialties, University of Health sciences of Libreville, Allée de Compiègne 3rd floor, apartment 13, 37000 Tours, France.
Jazyk: angličtina
Zdroj: Nephrologie & therapeutique [Nephrol Ther] 2019 Apr; Vol. 15 (2), pp. 91-96. Date of Electronic Publication: 2019 Feb 01.
DOI: 10.1016/j.nephro.2018.10.004
Abstrakt: Background: Acquired hyponatremia is a life threatening event. Intravenous infusion of a mixture of 5% glucose and sodium solute is mainly used, but its contribution in the occurrence of acquired hyponatremia in adult, is under-investigated outside intensive care unit.
Objective: To evaluate the place of intravenous infusion of a mixture of 5% glucose and sodium in predicting acquired hyponatremia in adult polyvalent medicine service.
Patients and Methods: A case-control study have been conducted. The main exposure was intravenous infusion of a mixture of 5% glucose and sodium solute (4 grams NaCl/liter of 5% glucose).
Outcome: Acquired hyponatremia during hospitalization. By logistic regression, the global multifactorial model predicting acquired hyponatremia, and its sub-models were established; as well as following parameters: area under the Receiving Operator Characteristic curve (AUC), maximal Youden's index with its couple of coordinates (sensibility-specificity), Nagelkerke's R-squared adjusted.
Results: Adjusted odds ratio (cases/controls; main exposure; outcome) OR a =2.73 (95% CI 1.40-5.32; P=0.003). Prediction of acquired hyponatremia: global multifactorial model: AUC=0.78 (95% CI 0.72-0.85; P<0.0001), Youden's index=0.34 (95% CI 0.24-0.41); sub-model (global multifactorial model without main exposure): AUC=0.72 (95% CI 0.66-0.78; P<0.0001), Youden's index=0.18 (95% CI 0.07-0.22).
Conclusion: Intravenous infusion of a mixture of 5% glucose and sodium mainly used, highly contribute to predict acquired hyponatremia in adult polyvalent medicine service, and should be the first cause to consider for managing this acquired hyponatremia.
(Copyright © 2018 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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