“DISNATREMIAS EN PACIENTES CON LESION CEREBRAL AGUDA SEVERA EN LA UNIDAD DE CUIDADOS INTENSIVOS DEL HOSPITAL LUIS VERNAZA DURANTE EL PERIODO MAYO 2017 – MAYO 2018”

Abstract

Sodium disorders are the most common and least understood electrolyte disorders in patients with acute brain injury due to the central role played by the central nervous system in the regulation of sodium and water homeostasis which can lead to serious complications and adverse outcomes including death. Complications can be minimized by a systematic approach to the recognition, diagnosis and treatment of sodium alterations. Objective: To evaluate the disnatremias in adult patients with severe acute brain injury interned in the intensive care unit of the Luis Vernaza Hospital. Methodology: An observational, retrospective and descriptive study was conducted with all the patients who entered the critical medicine area of the "Luis Vernaza" Hospital during the period from May 2107 to May 2018. The sample consisted of 82 patients between the ages of 20 At 79 years between women and men, the statistical analysis was performed with odds ratio (OR) and Pearson's relationship coefficient to respond to the objectives of the study. Results: The risk of presenting any type of dysnatremia studied in the present series was not significantly higher by type of acute brain injury, CPS and HSA: OR 1.4, 95% CI 0.5- 3.9. CPS and TEC OR 0.6 IC 95% 0.2 - 1.5. Both the CPS and the insipid diabetes increase the risk of presenting a decrease in extracellular volume with OR 5.1 with an IC 1.9-14 in the case of the CPS and OR 4 with an IC 1.4-10 in the DI. CPS increases the risk of mortality with an OR 5.6 and CI 2 - 15, which is statistically significant, DI does not increase mortality, and however, it is a predictor of brain death. The average of Apache the average of those who survived was 14 and those who died 15, in the sofa the average both for living and dead is 6, therefore the severity measured by these predictors was the same between the two groups. When sodium was taken as limit of hypernatremia 150 meq/L the mortality happened to be of 33%, whereas when it was taken with range of sodium normality of 135 -145 meq/L, mortality decreases to zero. Conclusions: The greatest risk of finding hypernatremia is in a patient with cranial encephalic trauma and intraparenchymal hemorrhage was associated with an increased risk of hyponatremia. CPS is a risk factor for mortality in patients with severe acute brain injury, while in the DI and SIADH no statistically significant values were found.