ArticleJournal of clinical medicine2020
ICU-Acquired Hypernatremia Is Associated with Persistent Inflammation, Immunosuppression and Catabolism Syndrome.
Article in Journal of clinical medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Risk factors, biomarkers, and mechanisms for persistent inflammation, immunosuppression, and catabolism syndrome (PICS): a systematic review and meta-analysis.British journal of anaesthesia · 2024Pooled it
- Association of hypernatremia with mortality in patients with COVID-19: A systematic review and meta-analysis.Immunity, inflammation and disease · 2023Pooled it
- Association between serum sodium and the risk of sepsis-related liver injury: a cross-sectional study based on the MIMIC-IV database.BMC infectious diseases · 2025Article
- An approach for the emergency diagnosis and treatment of sepsis-associated encephalopathy in elderly individuals: a literature review.World journal of emergency medicine · 2025Review
- Article
- The Urea-Creatinine Ratio as Marker of Catabolism Is Affected by Continuous Renal Replacement Therapy.Diagnostics (Basel, Switzerland) · 2025Article
- The Impact of Protein Feed on the Urea-to-Creatinine Ratio-A Retrospective Single-Center Study.Nutrients · 2025Article
- Prognostic impact of hypernatremia for septic shock patients in the intensive care unit.World journal of clinical cases · 2025Article
- Clinical practice guidelines for nutritional assessment and monitoring of adult ICU patients in China.Journal of intensive medicine · 2024Article
- Acute Gastrointestinal Injury in Polytrauma: Special Attention to Elderly Patients.International journal of medical sciences · 2024Observational
- Sodium-glucose co-transporter-2 inhibitors in the intensive care unit setting: Do we really need sodium increase, especially in sepsis?Critical care (London, England) · 2023Article
- Subphenotyping heterogeneous patients with chronic critical illness to guide individualised fluid balance treatment using machine learning: a retrospective cohort study.EClinicalMedicine · 2023Article
- Association of Hypernatremia with Immune Profiles and Clinical Outcomes in Adult Intensive Care Unit Patients with Sepsis.Biomedicines · 2022Article
- Article
- Association Between Serum Sodium and Long-Term Mortality in Critically Ill Patients with Comorbid Chronic Obstructive Pulmonary Disease: Analysis from the MIMIC-IV Database.International journal of chronic obstructive pulmonary disease · 2022Article
- Electrolyte and acid-base imbalance in severe COVID-19.Endocrine connections · 2021Article
- Fluid-induced harm in the hospital: look beyond volume and start considering sodium. From physiology towards recommendations for daily practice in hospitalized adults.Annals of intensive care · 2021Review
- Urinary Titin N-Fragment as a Biomarker of Muscle Atrophy, Intensive Care Unit-Acquired Weakness, and Possible Application for Post-Intensive Care Syndrome.Journal of clinical medicine · 2021Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Developing hypernatremia while on intensive care unit (ICU) is a common problem with various undesirable effects. A link to persistent inflammation, immunosuppression and catabolism syndrome (PICS) can be established in two ways. On the one hand, hypernatremia can lead to inflammation and catabolism via hyperosmolar cell stress, and on the other, profound catabolism can lead to hypernatremia via urea-induced osmotic diuresis. In this retrospective single-center study, we examined 115 patients with prolonged ICU stays (≥14 days) and sufficient renal function. Depending on their serum sodium concentrations between ICU day 7 and 21, allocation to a hypernatremic (high) and a nonhypernatremic group (low) took place. Distinct signs of PICS were detectable within the complete cohort. Thirty-three of them (28.7%) suffered from ICU-acquired hypernatremia, which was associated with explicitly higher signs of inflammation and ongoing catabolism as well as a prolonged ICU length of stay. Catabolism was discriminated better by the urea generation rate and the urea-to-creatinine ratio than by serum albumin concentration. An assignable cause for hypernatremia was the urea-induced osmotic diuresis. When dealing with ICU patients requiring prolonged treatment, hypernatremia should at least trigger thoughts on PICS as a contributing factor. In this regard, the urea-to-creatinine ratio is an easily accessible biomarker for catabolism.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.