Background

Hyponatremia is particularly common in the intensive care unit (ICU) w here both access to water and renal water handling are impaired in critically ill patients often afflicted with multiorgan system failure. To assess the incidence of hyponatremia among the patients admitted in ICU and to study their clinical profile.

Methodology

A prospective study was conducted in the respiratory care unit of R.G.Kar Medical College, Kolkata for a period of one year. All Adult patients above 18 years of age admitted in Respiratory care unit were included for the study. Patients with serum sodium level less than 135mmol/L were studied for clinical profile and patients with pseudo hyponatremia and hypertonic hyponatremia are excluded in our analysis.

Results 

In our study out of 358 patients admitted in ICU 128 patients had hyponatremia with a incidence rate of 35.7% among which 28.4% had sodium levels between 125 – 135 mmol/L and the remaining 9.4% had the sodium levels <125 mmol/L. Among the various types of hyponatremia euvolemic hypotonic was found to be the most common type of hyponatremia. SIADH (syndrome of inappropriate anti-diuretic hormone) was the most common cause for hyponatremia and pneumonia was found to be the most common cause for SIADH. Increase in age, presence of CNS symptoms, severe hyponatremia cases and increase in the duration of ICU stay are the various factors which influenced in causing death among the hyponatremia patients. 

Conclusion

Evaluating the cause for hyponatremia and treating it would prevent considerable morbidity and mortality  associated with this enigmatic electrolyte disorder.