| Background and Objective:Hypernatremia severe electrolyte imbalance status at all stages of thedevelopment of various diseases are often accompanied, the normal state we requireserum sodium concentration greater than145mmol/L is the presence ofhypernatremia, this condition often associated with plasma osmolality increases.Hypernatremia also ICU (Intensive Care Unit, ICU) prevalent severe electrolyteimbalance, studies have shown that the presence of hypernatremia about2%to6%ofhospital patients, and high sodium ICU iatrogenic hyperlipidemia incidence is about6.6%. Found in critically ill patients in clinical Once hypernatremia occurred,treatment is very difficult, very poor prognosis, the fatality rate of approximately10.2%~71.4%. Clinical treatment of critically ill patients noted hypernatremia wassignificantly higher than normal incidence of hospitalized patients, in addition,studies have reported a total mortality of patients with hypernatremia was69%,compared with non-hypernatremia critically ill patients died in hospital rate of6.5times, we can see that once the merger inpatient hypernatremia poor prognosis.Because the disease itself is more complex ICU patients, and the loss of part of thebody’s ability to self-regulate, so once hypernatremia occurred often more difficultto treat, so the clinician must exist sufficient attention hypernatremia, early detectionand rational management of liquid therapeutic measures. To further clarify hypernatremia in the ICU of the incidence and prognosis of ICU patients, this paperstudies related hypernatremia meta-analysis. To evaluate the incidence ofhypernatremia and its influence on mortality in intensive care unit (ICU) patients.Method:Pubmed, EMBase, Cochrane central registration of controlled trials, CNKI andWan Fang Data were searched, and relevant data of the stuty regarding hypernatremiain ICU patients published before September2013were retrieved. Meta analysis wasconducted with STATA12.0, and the effect of hypernatremia on hospital mortalityand ICU mortality was evaluated.Results:1.The detection network to retrieve articles528, according to the inclusion andexclusion criteria were further screened Article14.The pooled results from14atriclesfrom449ICU in9countries involving365103patients.2.The results showed that the morbidity of hypernatremia in ICU was6.9%(25326/365103），the mortality rate was32.7%（8291/25326）.3.The mortality of non-hypernatremia patients was11.9%(40588/339777）；But the mortality of hypernatremia patients was about2.75times higher thannon-hypernatremia patients.4.In patients with hypernatremia, the mortality of iatrogenic hypernatremia[31.6%(3790/11976)],wnich was similar to that of non-iatrogenic hypernatremia[33.7%(4501/13350)].5.Further Meta analysis showed that hypernatremia was an independent riskfactor of hospital mortality [reative risk (RR)1.85,95%confidence interval(95%CI)1.53～2.23]，and ICU mortality [RR2.65,95%CI1.83～3.84], but the heterogeneitywas high.6.The source of heterogeneity was found with subgroup analysis according tosample size（>1000cases or≤1000cases）, ICU type(surgery ICU or other types),study type(retrospective cohort study, prospective cohort study or case-control study), hypernatremia type (iatrogenic hypernatremia or not).Funnel plot showed nopublication bias.7.Hypernatremia can significantly prolong the patient’s hospital stay.Conclusion:Hypernatremia as an independent risk factor for mortality in patients, cansignificantly increase hospital mortality in patients with a direct impact on patientoutcomes, and increase the length of stay for patients. Clinicians should cause enoughattention, once hypernatremia appears to be the first time to find the cause, aggressivetreatment. |
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