scholarly journals Intravenous Infusion of Sterile Water for the Treatment of Hypernatraemia

2014 ◽  
Vol 42 (2) ◽  
pp. 258-262
Author(s):  
H. Ramaswamykanive ◽  
J. Greaves
Keyword(s):  
Insulin Infusion ◽  
Serum Sodium Level ◽  
Central Line ◽  
Sterile Water ◽  
Review Of The Literature ◽  
Lower Serum ◽  
Off Label ◽  
Contentious Issue ◽  
Water Infusion ◽  
Extensive Search

Little research has been carried out into the infusion of intravenous sterile water for the treatment of hypernatraemia, and it remains a contentious issue. We conducted a review of the literature and extract results following an extensive search of Medline 1946, Embase 1974, ProQuest, evidence-based practice resources, national and international guideline sites and the publications of various professional bodies. The review is presented on the infusion of sterile water (hypotonic fluid) to lower serum sodium level in those circumstances when enteral supplementation of water is not possible, such as in postoperative patients or when other isotonic fluids (such as 5% dextrose in water infusion) are less than ideal—for example, hyperglycaemic patients on an insulin infusion. Absence of guidelines has limited the use of sterile water, even as an off-label drug when it can be administered relatively safely via a central line.

scholarly journals Successful free flap salvage surgery with off-label use of Alteplase: A case report, review of the literature and our free flap salvage algorithm

2020 ◽  
Vol 75 ◽  
pp. 398-402
Author(s):  
Fatima Barhoum ◽  
Klaus Tschaikowsky ◽  
Michael Koch ◽  
Markus Kapsreiter ◽  
Matti Sievert ◽  
...  
Keyword(s):  
Case Report ◽  
Free Flap ◽  
Salvage Surgery ◽  
Off Label Use ◽  
Review Of The Literature ◽  
Off Label ◽  
Label Use

scholarly journals ACUTE AORTIC DISSECTION IN A POSTMENOPAUSAL FEMALE IN THE SETTING OF PARENTERAL TESTOSTERONE, ESTRADIOL, AND PROGESTERONE THERAPY

2019 ◽  
Vol 5 (5) ◽  
pp. e287-e289
Author(s):  
Michael Zeihen ◽  
Daniel Mattox ◽  
Timothy Sanborn ◽  
Michael Kreager ◽  
Raaid Museitif ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Thoracic Aorta ◽  
Acute Aortic Dissection ◽  
Aortic Disease ◽  
Review Of The Literature ◽  
Free Standing ◽  
Testosterone Therapy ◽  
Laboratory Findings ◽  
Off Label ◽  
Postmenopausal Female

Objective: The FDA has not approved the use of testosterone in women. However, parenteral testosterone is being used off-label in free standing clinics throughout America. The recent multi-ethnic study of atherosclerosis (MESA) population study showed that postmenopausal women with a higher testosterone/estradiol ratio had a higher incident of cardiovascular disease. This is a case of a postmenopausal woman who dissected her thoracic aorta after 8 months of parenteral testosterone. Methods: The clinical examination, radiographic, and laboratory findings of a patient are presented along with a review of the literature. Results: A heathy postmenopausal women, whose only risk factor was parenteral testosterone, developed a dissection of her entire thoracic aorta. Conclusion: The MESA study and other conflicting publications on cardiovascular events in transgender patients receiving exogenous androgens indicates the need for further investigation to determine the safety of testosterone therapy for women and its possible role in contributing to aortic disease.

scholarly journals Successful free flap revision with off-label use of Alteplase: A case report and review of the literature

2018 ◽  
Author(s):  
F Barhoum ◽  
M Koch ◽  
K Tschaikowsy ◽  
M Sievert ◽  
H Iro ◽  
...  
Keyword(s):  
Case Report ◽  
Free Flap ◽  
Off Label Use ◽  
Review Of The Literature ◽  
Off Label ◽  
Label Use

scholarly journals Vocal cord paralysis following central line insertion in a neonate: a review of the literature

2011 ◽  
Vol 2011 (jul14 1) ◽  
pp. bcr1120103543-bcr1120103543 ◽  
Author(s):  
F. A. Arshad ◽  
C. Y. Eng ◽  
W. Daw ◽  
M. S. Thevasagayem ◽  
N. Bateman
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Central Line ◽  
Review Of The Literature ◽  
Central Line Insertion ◽  
Line Insertion

scholarly journals Association between lower serum sodium levels and clinical outcomes in insomnia patients

2020 ◽  
Author(s):  
Eunjin Bae ◽  
Tae Won Lee ◽  
Ha Nee Jang ◽  
Hyun Seop Cho ◽  
Se-Ho Chang ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Serum Sodium ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Kidney Injury ◽  
Chronic Respiratory Disease ◽  
Lower Serum ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
Calcium Phosphorus

Abstract Background The association of lower serum sodium levels with clinical outcomes in insomnia patients remains unclear. We explored whether lower serum sodium is associated with poor clinical outcomes in patients with insomnia. Methods We retrospectively enrolled patients with a diagnosis of insomnia from January 2011 to December 2012. We divided participants into three groups according to initial serum sodium level: tertile 1 (< 138 mmol/L), tertile 2 (138.0–140.9 mmol/L), and tertile 3 (≥ 141.0 mmol/L). To calculate the relative risk of death, hazard ratios (HRs) and 95% confidence intervals (CIs) were obtained using Cox proportional hazard models. Result A total of 412 patients with insomnia were included, of whom 13.6% (n = 56) had hyponatremia. Patients with lower serum sodium concentrations were older and had lower hemoglobin, calcium, phosphorus, and albumin levels. At the median follow-up of 49.4 months, 44 patients had died and 62 experienced acute kidney injury (AKI). Kaplan-Meier analysis showed significantly higher mortality in patients in the lowest tertile for serum sodium. Lowest tertile of serum sodium, AKI, and chronic respiratory disease were associated with all-cause mortality. In addition, lowest tertile of serum sodium was also significantly associated with AKI. Conclusions The lowest tertile of serum sodium was associated with a higher mortality and AKI rate in insomnia patients. Our results suggest serum sodium level could be used one of the prognostic factor in insomniacs and physicians should be careful to take care of them when they present lower sodium level.

scholarly journals Lower serum sodium level predicts poor clinical outcomes in patients with insomnia

2020 ◽  
Author(s):  
Eunjin Bae ◽  
Tae Won Lee ◽  
Ha Nee Jang ◽  
Hyun Seop Cho ◽  
Sehyun Jung ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Serum Sodium ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Kidney Injury ◽  
Lower Serum ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Calcium Phosphorus

Abstract Background The association of lower serum sodium levels with clinical outcomes in insomnia patients remains unclear. We explored whether lower serum sodium is associated with poor clinical outcomes in patients with insomnia. Methods We retrospectively enrolled patients with a diagnosis of insomnia from January 2011 to December 2012. We divided participants into three groups according to initial serum sodium level: tertile 1 (< 138 mmol/L), tertile 2 (138.0–140.9 mmol/L), and tertile 3 (≥ 141.0 mmol/L). To calculate the relative risk of death, hazard ratios (HRs) and 95% confidence intervals (CIs) were obtained using Cox proportional hazard models. Result A total of 412 patients with insomnia were included, of whom 13.6% (n = 56) had hyponatremia. Patients with lower serum sodium concentrations were older and had lower hemoglobin, calcium, phosphorus, and albumin levels. At the median follow-up of 49.4 months, 44 patients had died and 62 experienced acute kidney injury (AKI). Kaplan-Meier analysis showed significantly higher mortality in patients in the lowest tertile for serum sodium. Lowest tertile of serum sodium, and AKI were associated with all-cause mortality. However, lowest tertile of serum sodium was not significantly associated with AKI. Conclusions The lowest tertile of serum sodium was associated with a higher mortality rate in insomnia patients. Our results suggest serum sodium level could be used one of the prognostic factor in insomniacs and physicians should be careful to take care of them when they present lower sodium level.

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