Critical illness with hyponatraemia and impaired cell membrane integrity--the 'sick cell syndrome' revisited
| Autor: | Geoffrey Gill, Patrick English, Ian D. Watson, Jacqueline C. Osypiw, Euan Shearer |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Cell Membrane Permeability Lymphocyte Critical Illness Multiple Organ Failure Clinical Biochemistry Cell Water-Electrolyte Imbalance Gastroenterology Flow cytometry law.invention Cell membrane Liver disease chemistry.chemical_compound Fatal Outcome law Impaired Cell Membrane Integrity Internal medicine medicine Humans Propidium iodide Lymphocytes Aged medicine.diagnostic_test business.industry Liver Diseases General Medicine medicine.disease Flow Cytometry Intensive care unit medicine.anatomical_structure chemistry Female business Hyponatremia |
| Zdroj: | Clinical biochemistry. 38(11) |
| ISSN: | 0009-9120 |
| Popis: | Objective: To determine whether impaired cell membrane permeability exists in critically ill patients with “sick cell” type hyponatraemia. Design and methods: A 36 year old male patient was identified in an intensive care unit (ICU) with liver disease and multi-organ failure. His initial serum sodium (Na) was 101 mmol/L and osmolar gap + 35 mmol/L. A flow cytometric system was used to assess lymphocyte membrane integrity using fluorescein diacetate (FDA) and propidium iodide (PI). Following this, similar studies were carried out in 17 hyponatraemic (Na 136 mmol/L) ICU patients. Results: Flow cytometry in the index patient showed two clear populations of cells—one was normal (with identical characteristics to a healthy control) and the other had dysfunctional cell membrane integrity. The extended patient series, however, revealed only 2 other patients with similar flow cytometric patterns—one hyponatraemic and one normonatraemic. Conclusions: Cell membrane studies in the index patient demonstrated supportive evidence for the “sick cell syndrome” in critically ill patients. The extended series revealed that 3/37 (8%) had this abnormality, which was however not consistently associated with hyponatraemia. |
| Databáze: | OpenAIRE |
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