Compre o eBook Interpretação Clínica do Metabolismo Hidroeletrolítico e do equilíbrio hidroeletrolítico, ou seja, da água, dos sais e do distúrbio ácido-básico. Hiponatremia é o distúrbio hidroeletrolítico mais comum em pacientes hospitalizados. A presença de hiponatremia está associada a uma série de desfechos. dissociação proteino-citológica relativa (6) e séptica (4), hipoglicorraquia moderada (4%), hipoglicorraquia severa (4%), distúrbio hidroeletrolítico (3%).

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There was little correlation between CSF syndromes and clinical data.

Given the high frequency of antibodies against Toxoplama gondii in asymptomatic HIV-positive patients, this might be interpreted with hidrieletrolitico 9. However, it has been described in HIV-positive patients, since early in the infection.

In such situations, urine will be dilute, indicating that kidneys are trying to excrete excess water. The velocity with which hyponatremia develops is an essential factor in determining symptomatology. Hypovolemic hyponatremias tend to be mild and they usually do not dominate the patient’s clinical picture.

For example, a moderate acute hyponatremia may be more symptomatic than a severe chronic hyponatremia. Commonly, HIV-positive patients present to emergency rooms with acute alterations of consciousness.

Mechanisms Involved in Fluid and Solute Imbalance.

Riella Disturbios Hidroeletroliticos – Capítulo do livro de Nefrologia de Riella

Establishing an etiological diagnosis also helps to determine the most appropriate sodium chloride ditsurbio normal versus hypertonic saline. Up to Date v. Chronically, patients may be hodroeletrolitico in a high solute diet same rational as hypertonic salineoral furosemide, vaptans, lithium and demeclocycline.


Since neurological damage resulting from pontine myelinolysis is frequently irreversible, the best alternative is prevention. Since serum osmolality analysis is not performed in many Brazilian hospitals and laboratories and, when it is, the result may take a whilein practice, it is very common to rule out pseudohyponatremia based on readily available clinical and laboratory data, such as serum glucose, total proteins and fractions, and lipid profile.

Cerebrospinal fluid syndromes in HIV-positive patients with acute consciousness compromise

Am J Psychiatry ; Depending on the severity and duration of hyponatremia, symptoms may range from absent to full-blown encephalopathy, coma and seizures. Besides, Neves, found that the CSF analysis confirmed a clinical hypothesis in This is in agreement with the epidemiological distribution of AIDS at the time of the study. Revista da Sociedade Brasileira de Medicina Tropical Sodium metabolism and maintenance of extracellular fluid volume. The CSF analysis showed abnormal results in 77 patients, as is shown in Table 1.

Tex Med ; We found little association between clinical data and CSF syndromes. Urinary sodium is low and urine osmolality is high, demonstrating an appropriate salt and water retention in response to the true hypovolemia. Much problably, this indicate alterations induced by the own HIV, since no patient had history of other CNS infection. The contribution of the CSF analysis in the evaluation of these patients must be considered in the setting of an acute presentation of a chronic patient. When faced with a hyponatremic patient, the first step should be to rule out pseudohyponatremia.

The correlation between these reactions and other CSF results is in Table 2. The predominance of neurological and infectious signs and symptoms reflect our inclusion criteria. Because of its glucose content, beer not only reduces hunger, but also minimizes protein catabolism.


Renal, adrenal and thyroid functions must be normal to fit this diagnosis. It is still not clear if there is a direct causal relationship or if hyponatremia is simply a marker of disease severity. This paper addresses the basic pathophysiologic concepts about hyponatremia followed by a practical approach to its diagnosis and management. Anesth Analg ; A potential pitfall in therapy.

J Bras Nefrol ; Etiology and diagnostic investigation When faced with a hyponatremic patient, the first step should be to rule out pseudohyponatremia. Capillary permeability of protein as a factor in the control of plasma volume.

Hyponatremia is the most common electrolyte imbalance in hospitalized patients. In Brazil, hypertonic saline is not commercially available, so the solution has to be mixed by the nursing staff Table 5. Urinary sodium is low and urine osmolality is high, demonstrating an appropriate salt and water retention in response to the true hypovolemia Hypervolemia History and physical examination suggest an edematous syndrome, such as CHF, cirrhosis or nephrotic syndrome.

If the patient is hyponatremic and serum osmolality is normal or high, he is said to have pseudohyponatremia. Cecil Textbook of Medici- ne, W.

Pathophysiology of edema formation. Treatment of severe hypovolemia or hypo- volemic shock.