To investigate sodium abnormalities in a cohort of consecutive patients on chronic mechanical ventilation admitted to a long-term facility (chronic care hospital, CCH).
Retrospective, single center, observational cohort study of CCH patients admitted between November 2007 to September 2008.Subjects were included in the study during the set time period. A database was constructed with information from electronic records. Sodium and other electrolytes were gathered during admission, week two and discharge. Normal sodium range was set at 136 to 145 mEq/L.
Eighty-six patients were admitted, 43% were female. Fifty-five patients (63%) came from a Medical Intensive Care Unit and thirty-one (37%) from a Surgical Intensive Care Unit. The mean age was sixty-six years old. On admission 14 of 86 patients (16%) were hypernatremic with a mean sodium of 149.5 mEq/L and 13 patients (15%) were hyponatremic with a mean sodium of 132.9 mEq/L. Twenty-four patients (28%) with normal sodium on admission had abnormal levels during the second week or at discharge. Twenty eight patients (32%) died and of those, twenty (71%) had a sodium abnormality on admission or during their hospital stay, twenty eight patients (32%) were discharged home, fourteen (50%) of them had a sodium abnormality at any point during their hospital stay.
A high proportion of patients (31%) on chronic mechanical ventilation have sodium abnormalities on admission. Twenty-eight percent of patients with a normal sodium on admission developed and abnormal sodium during their stay at CCH.
Dysnatremia is a frequent phenomenon in chronically ventilated patients. This may be associated with higher mortality and longer stay. Further investigation is necessary to correlate these findings with patient outcomes.
Alfredo Vazquez Sandoval, No Financial Disclosure Information; No Product/Research Disclosure Information