Individuals most susceptible to hyponatremic brain damage

Although previous medical opinion suggested that major factors which might lead to permanent brain damage were related to the magnitude and duration of the hyponatremia, recent studies have demonstrated that neither were important factors associated with the development of brain damage (Ayus.etal 1992). Rather, the age, gender, and reproductive (hormonal) status of the patient, as well as the presence of encephalopathy, were the most important predictive factors. The most susceptible groups were menstruant women and prepubescent children (Fraser...and...Ari®f!...199.0.; Ayy.§ ®Lal.: 1992). Suggestions that patients with 'chronic'

hyponatremia are more likely than those with 'acute' hyponatremia to develop brain damage as a complication of therapy with hypertonic NaCl are not supported by clinical evidence. Improper therapy can lead to permanent brain damage in hyponatremic patients, but the vast majority who develop complications have had essentially no therapy for their hyponatremia (F.r§„s®r.. ..a.Od A.r!eff... Improper therapy may be a factor in at most about 4 per cent of brain damage associated with hyponatremia (Ay.ys §Dd Ar.i.eff 1996) (Fig 1). Timely treatment of symptomatic hyponatremia with respiratory support and carefully administered hypertonic NaCl is usually associated with recovery (Ayy.§...§.La! 1992).

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