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Keyword
Hypernatremia
Definition
Na > 145mEq/L (>160mEq/L인 경우 severe)
Signs & Symptoms
- Mental change
- Irritability
- Seizure
- spasticity
Diagnosis
- Intravascular volume status
- Urine osmolality
- Na 농도
Mechanism
- Excessive water loss
- ADH 분비저하 (Central DI) or renal sensitivity 저하 (Nephrogenic DI)
- 과량 섭취
Treatment
Intravascular volume status에 따라 치료 달라지지만, 10mEq/L/day의 속도를 넘지 않도록.
- Hypovolemic : Replace isotonic loss & water deficit
- Euvolemic :
- Hypervolemic : Na 섭취 중단시킨 후 이뇨제 투여
Reference
Miller’s Anesthesia, 8th edition, P.1790 ~ 1791
Morgan & Mikhail’s Clinical anesthesiology 5th ed. P. 1114 ~ 1117
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