Prognostic impact of hypernatremia for septic shock patients in the intensive care unit  

作　　者：Mai-Qing Shi Jun Chen Fu-Hai Ji Hao Zhou Ke Peng Jun Wang Chun-Lei Fan Xu Wang Yang Wang 

机构地区：[1]Department of Anesthesiology,The First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu Province,China [2]Department of General Surgery,The First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu Province,China [3]Intensive Care Medicine,The First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu Province,China

出　　处：《World Journal of Clinical Cases》2025年第7期28-38,共11页世界临床病例杂志（英文）

基　　金：Supported by The National Natural Science Foundation of China,No.82072130;Key Medical Research Projects in Jiangsu Province,No.ZD2022021;Suzhou Clinical Medical Center for Anesthesiology,No.Szlcyxzxj202102。

摘　　要：BACKGROUND Hypernatremia represents a significant electrolyte imbalance associated with numerous adverse outcomes,particularly in cases of intensive care unit(ICU)-acquired hypernatremia(IAH).Nevertheless,its relevance in patients with septic shock remains uncertain.AIM To identify independent risk factors and their predictive efficacy for IAH to improve outcomes in patients with septic shock.METHODS In the present retrospective single-center study,a cohort of 157 septic shock patients with concurrent hypernatremia in the ICU at The First Affiliated Hospital of Soochow University,between August 1,2018,and May 31,2023,were analyzed.Patients were categorized based on the timing of hypernatremia occurrence into the IAH group(n=62),the non-IAH group(n=41),and the normonatremia group(n=54).RESULTS In the present study,there was a significant association between the high serum sodium concentrations,excessive persistent inflammation,immunosuppression and catabolism syndrome and chronic critical illness,while rapid recovery had an apparent association with normonatremia.Moreover,multivariable analyses revealed the following independent risk factors for IAH:Total urinary output over the preceding three days[odds ratio(OR)=1.09;95%CI:1.02–1.17;P=0.014],enteral nutrition(EN)sodium content of 500 mg(OR=2.93;95%CI:1.13–7.60;P=0.027),and EN sodium content of 670 mg(OR=6.19;95%CI:1.75–21.98;P=0.005)were positively correlated with the development of IAH.Notably,the area under the curve for total urinary output over the preceding three days was 0.800(95%CI:0.678–0.922,P=0.001).Furthermore,maximum serum sodium levels,the duration of hypernatremia,and varying sodium correction rates were significantly associated with 28-day in-hospital mortality in septic shock patients(P<0.05).CONCLUSION The present findings illustrate that elevated serum sodium level was significantly associated with a poor prognosis in septic shock patients in the ICU.It is highly recommended that hypernatremia be considered a potentially important progn

关 键 词：HYPERNATREMIA Hypernatremia acquired in the intensive care unit Septic shock Persistent inflammation IMMUNOSUPPRESSION Catabolism syndrome Chronic critical illness Prognosis 

分 类 号：R692[医药卫生—泌尿科学]