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European Journal of Trauma and Emergency Surgery

Published in:

01-02-2016 | Original Article

Increase in urinary sodium excretion in spinal cord injury patients in the emergency department

Authors: R. Kogawa, K. Kinoshita, K. Tanjoh

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2016

Abstract

Objective

Spinal cord injury (SCI) is a pathological condition known to produce hyponatremia. The aim of this study was to elucidate the dynamics of urinary sodium excretion in patients with spinal cord injury.

Methods

SCI patients undergoing intensive care management were enrolled in this study. These patients were divided into two groups: those with Frankel Grade A spinal cord injury manifesting complete, severe motor disorders (FA group) and those with incomplete spinal cord injury (non-FA group). The occurrence of episode of hyponatremia (serum sodium <135 mmol/L), hypotension, and bradycardia during the first 14 hospital days was counted and fractional excretion of sodium (FE_Na) was calculated on the 1st, 7th, and 14th hospital days.

Results

Thirty-four patients (FA group, n = 9; non-FA group, n = 25) were included. Eight patients (88.9 %) in the FA group and three patients (12 %) in the non-FA group experienced at least one episode of hyponatremia during the first 14 hospital days. In the FA group, the FE_Na was significantly increased on the 7th and 14th hospital days compared to the 1st hospital day. FE_Na on the 14th hospital day was a significant independent predictor of hyponatremic episodes. Hypotension and bradycardia as the symptoms of sympathetic blockade differed significantly as independent predictors of increased FE_Na on the 14th hospital day.

Conclusion

Urinary sodium excretion calculated by FE_Na increased in patients with severe spinal cord injury. Sympathetic blockade due to SCI may increase urine sodium excretion and lead to hyponatremia.

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Title: Increase in urinary sodium excretion in spinal cord injury patients in the emergency department
Authors: R. Kogawa
K. Kinoshita
K. Tanjoh
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 1/2016
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-015-0503-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Increase in urinary sodium excretion in spinal cord injury patients in the emergency department

Abstract

Objective

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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