Hipernatremia: uma revisão
Palavras-chave:
desidratação, diabetes insípida, hipernatrémia, hormona antidiuréticaResumo
A conservação renal de água e a sede constituem os dois mecanismos essenciais no combate da hipernatremia. Nos indivíduos não hospitalizados, a hipernatremia ocorre sobretudo nos idosos, resultante mais frequentemente da desidratação que as infecções acarretam. Em doentes hospitalizados, surge por errada administração de soros em indivíduos com alteração do estado de consciência, ou incapacidade de aceder à água. Em resposta à hipernatremia, o cérebro desencadeia uma série de mecanismos destinados a evitar a desidratação neuronal. Ao rápido up-take de electrólitos, segue-se uma fase mais lenta, de acumulação de osmolitos orgânicos. O tratamento da hipernatremia passa pela infusão de líquidos, em que a velocidade de infusão, a ocorrer de forma segura, será ditada pela taxa de remoção dos referidos solutos. A mortalidade varia entre 40 a 60%.
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