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Extreme hypernatremia in a critically ill patient with feeding-jejunostomy: a case report

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Kumar A., Singh K., Kumari P., Dara H., Sagdeo G.

Critical Care Innovations

2023

vol. 6

issue 1

36-40

Hypernatremia is a frequent and potentially life-threatening condition in hospitalized patients. It is a disorder of water metabolism and is usually defined as a plasma sodium concentration above 145 mEq/L. The treatment of severe cases of hypernatremia might be challenging in patient with feeding jejunostomy. The average person’s GI tract secretes and reabsorbs around 7 L of gastrointestinal fluid (including 3-5 L originating above the pylorus alone). These 7 L of gastrointestinal fluid will significantly dilute whatever we consume or infuse. However, this dilution of enteral feed may be bypassed in by feeding jejunostomy. There are very few cases reported on extreme hypernatremia. We present a case of severe hypernatremia in patient with feeding-jejunostomy, managed successfully with the recommended correction.

Short-term proton pump inhibitor treatment may cause hypomagnesaemia in critically ill patients - a pilot study

100%

Krzych Ł., Łój P., Nowak T., Kazura W., Knapik P.

Acta Biochimica Polonica

2017

vol. 64

issue 3

499-501

Many studies have suggested a link between long-term PPI treatment and hypomagnesaemia, though none of them investigated the short-term exposure in high-risk patients. We sought to investigate this issue in 90 critically ill patients. We assessed serum Mg concentrations, necessity of Mg supplementation, PPI dose, duration of PPI therapy and route of administration. In multiple analysis we found that Mg supplementation (positive effect/p=0.03) and enteral route of PPI administration (negative effect/p=0.02) had significant impact on Mg concentration. Although the deleterious relationship between short-term PPI treatment and Mg concentration was found, further studies should be provided to confirm this interesting effect.

Serum levels of the S100B protein and neuron-specific enolase are associated with mortality in critically ill patients

100%

Duda I., Krzych Ł., Jędrzejowska-Szypułka H., Lewin-Kowalik J.

Acta Biochimica Polonica

2017

vol. 64

issue 4

647-652

Introduction. Evaluation of the prognostic potential of the S100B protein and neuron-specific enolase (NSE) as predictors of mortality in critically ill patients in intensive care units (ICU). Materials and Methods. The study was conducted on 62 patients. Basic clinical variables and blood samples for S100B and NSE level testing were obtained during the first four days after admission. Mortality was described as the patient's death during hospitalization in the ICU. Results. 35% of the patients had died. The level of S100B and NSE was significantly higher in non-survivors in comparison with survivors (p=0.007 and p=0.02, respectively). Mortality risk was significantly higher in patients with higher levels of biomarkers than the reference values for S100B (OR 9.00; 95% CI 2.38-33.99; p<0.001) as well as for NSE (OR 5.75; 95%CI 1.31-25.27; p=0.016). Receiver operating characteristic proved that S100B is a better mortality predictor than NSE (AUC 0.76 for S100B and 0.68 for NSE). From all the other variables, the Apache II score turned out to be the only significant predictor of mortality (AUC 0.88). Conclusion. There is a significant correlation between mortality in the ICU and increased serum concentration of S100B and NSE. This correlation is stronger for S100B. Testing for serum levels of S100B and NSE may be useful for prediction of treatment outcomes in the ICU patients.

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2 Acta Biochimica Polonica

1 Critical Care Innovations

1 2023

2 2017

2 Krzych Ł.

1 Dara H.

1 Duda I.

1 Jędrzejowska-Szypułka H.

1 Kazura W.

1 Knapik P.

1 Kumar A.

1 Kumari P.

1 Lewin-Kowalik J.

1 Nowak T.

1 Sagdeo G.

1 Singh K.

1 Łój P.

Search results

Extreme hypernatremia in a critically ill patient with feeding-jejunostomy: a case report

Short-term proton pump inhibitor treatment may cause hypomagnesaemia in critically ill patients - a pilot study

Serum levels of the S100B protein and neuron-specific enolase are associated with mortality in critically ill patients