| Title |
Tolvaptan for hyponatremia with preserved sodium pool in critically ill patients
|
|---|---|
| Published in |
Annals of Intensive Care, January 2016
|
| DOI | 10.1186/s13613-015-0096-2 |
| Pubmed ID | |
| Authors |
Michele Umbrello, Elena S. Mantovani, Paolo Formenti, Claudia Casiraghi, Davide Ottolina, Martina Taverna, Angelo Pezzi, Giovanni Mistraletti, Gaetano Iapichino |
| Abstract |
Hyponatremia is the most common electrolyte disturbance in hospitalized patients, and it represents a well-established risk factor for ICU/hospital mortality. The majority of hyponatremic states are associated with elevated arginine vasopressin levels and a preserved sodium pool. Conventional treatment is either not pathophysiologically oriented or of limited effectiveness. The aim of the present study is to investigate the use of enteral Tolvaptan in critically ill hyponatremic patients. This is a retrospective observational study in a general ICU. Patients with preserved sodium pool hyponatremia refractory to conventional therapy were enrolled. The hemodynamic, renal, and hepatic functions, together with sodium and water balance as close as possible to the drug administration and up to 72 h thereafter, were analyzed. The main outcome was a serum sodium increase of ≥ 4 mmol/L in 24 h; secondary endpoints were the ability to maintain serum sodium at 24 and 72 h, a decrease in urine sodium concentration and an increase in sodium-free diuresis. 38 patients were enrolled. The average dose of enteral Tolvaptan was 7.5 mg. 31 patients (81.6 %) increased their serum sodium >4 mmol/l/24 h; the average increase was 6.7 ± 3.4 mmol/l during the first 24 h (p < 0.001 vs baseline), and this was sustained at 72 h. No adverse effects were reported. Plasma sodium (R = -0.622, p < 0.001), urine sodium (R = -0.345, p < 0.001), central venous oxygen saturation (R = 0.401, p = 0.013), and BUN (R = -0.416, p = 0.031) before Tolvaptan were all significantly correlated with the absolute increase in serum sodium after the administration. Enteral administration of Tolvaptan seems effective in the treatment of hyponatremia with preserved sodium pool in critically ill patients. Even if the study was underpowered to detect significant side effects or complications of unwarranted fast corrections of hyponatremia, we report no complications. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 29 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Italy | 1 | 3% |
| Unknown | 28 | 97% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 7 | 24% |
| Other | 4 | 14% |
| Student > Postgraduate | 4 | 14% |
| Student > Doctoral Student | 3 | 10% |
| Professor > Associate Professor | 3 | 10% |
| Other | 5 | 17% |
| Unknown | 3 | 10% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 21 | 72% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 3% |
| Unspecified | 1 | 3% |
| Agricultural and Biological Sciences | 1 | 3% |
| Biochemistry, Genetics and Molecular Biology | 1 | 3% |
| Other | 0 | 0% |
| Unknown | 4 | 14% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 January 2016.
All research outputs
#20,300,248
of 22,837,982 outputs
Outputs from Annals of Intensive Care
#955
of 1,043 outputs
Outputs of similar age
#330,211
of 393,291 outputs
Outputs of similar age from Annals of Intensive Care
#25
of 31 outputs
Altmetric has tracked 22,837,982 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,043 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.7. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 393,291 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 31 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.