ArticleIntensive care medicine2013
Rising serum sodium levels are associated with a concurrent development of metabolic alkalosis in critically ill patients.
Article in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 24 citations in OpenAlex.
- Compared effects of calcium and sodium polystyrene sulfonate on mineral and bone metabolism and volume overload in pre-dialysis patients with hyperkalemia.Clinical and experimental nephrology · 2018Trial
- Machine Learning Techniques for the Analysis of the Influence of Blood Gasometry Parameters on Acid-Base Homeostasis in Pediatric Patients.Diagnostics (Basel, Switzerland) · 2025Article
- Buffers in intravenous solutions: is the source of bicarbonate a source of confusion?Critical care (London, England) · 2025Review
- Acid-Base Status in Critically Ill Patients: Physicochemical vs. Traditional Approach.Journal of clinical medicine · 2025Article
- Enteral free water vs. parenteral dextrose 5% in water for the treatment of hypernatremia in the intensive care unit: a retrospective cohort study from a mixed ICU.Journal of anesthesia · 2023Article
- Fluid and electrolyte overload in critically ill patients: An overview.World journal of critical care medicine · 2015Review
- Increased serum bicarbonate in critically ill patients: a retrospective analysis.Intensive care medicine · 2015Article
- Evaporation of free water causes concentrational alkalosis in vitro.Wiener klinische Wochenschrift · 2014Article
- Metabolic alkalosis is the most common acid-base disorder in ICU patients.Critical care (London, England) · 2014Article
- Year in review in Intensive Care Medicine 2013: I. Acute kidney injury, ultrasound, hemodynamics, cardiac arrest, transfusion, neurocritical care, and nutrition.Intensive care medicine · 2014Article
- The importance of the ionic product for water to understand the physiology of the acid-base balance in humans.BioMed research international · 2014Review
- Hypernatremic alkalosis or chloride depletion alkalosis? Reply to Vasconcelos et al.Intensive care medicine · 2013Article
- Hypernatremic alkalosis or chloride depletion alkalosis?Intensive care medicine · 2013Article
- [Disorders of serum sodium in emergency patients : salt in the soup of emergency medicine].Der Anaesthesist · 2013Review
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeChanges in electrolyte homeostasis are important causes of acid-base disorders. While the effects of chloride are well studied, only little is known of the potential contributions of sodium to metabolic acid-base state. Thus, we investigated the effects of intensive care unit (ICU)-acquired hypernatremia on acid-base state.
methodsWe included critically ill patients who developed hypernatremia, defined as a serum sodium concentration exceeding 149 mmol/L, after ICU admission in this retrospective study. Data on electrolyte and acid-base state in all included patients were gathered in order to analyze the effects of hypernatremia on metabolic acid-base state by use of the physical-chemical approach.
resultsA total of 51 patients were included in the study. The time of rising serum sodium and hypernatremia was accompanied by metabolic alkalosis. A transient increase in total base excess (standard base excess from 0.1 to 5.5 mmol/L) paralleled by a transient increase in the base excess due to sodium (base excess sodium from 0.7 to 4.1 mmol/L) could be observed. The other determinants of metabolic acid-base state remained stable. The increase in base excess was accompanied by a slight increase in overall pH (from 7.392 to 7.429, standard base excess from 0.1 to 5.5 mmol/L).
conclusionsHypernatremia is accompanied by metabolic alkalosis and an increase in pH. Given the high prevalence of hypernatremia, especially in critically ill patients, hypernatremic alkalosis should be part of the differential diagnosis of metabolic acid-base disorders.
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