ArticleCritical care (London, England)2023
Dysnatremia at ICU admission and functional outcome of cardiac arrest: insights from four randomised controlled trials.
Article in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01994772 (Therapeutic Hypothermia After Cardiac Arrest in Non Shockable Rhythm at Rescue Arrival), which is not on this map. Cited by 9 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Therapeutic Hypothermia After Cardiac Arrest in Non Shockable Rhythm at Rescue Arrival: The HYPERION Study
Who cites it
9 citing papers in PubMed.
- Singapore Post-cardiac Arrest Care Guidelines 2026.Singapore medical journal · 2026Review
- Comparison of intravenous and intraosseous administration of vasopressin and epinephrine during cardiopulmonary resuscitation of asphyxiated neonatal piglets.Pediatric research · 2026Article
- Development of a Clinical Prediction Model for Acute Kidney Injury Among In-Hospital Cardiac Arrest Patients During Intensive Care Unit Hospitalization.Reviews in cardiovascular medicine · 2026Article
- Osmolarity trajectories and outcomes in patients with acute pancreatitis in the intensive care unit: group-based trajectory modeling.BMC medical informatics and decision making · 2025Article
- A Contemporary Narrative Review of Sodium Homeostasis Mechanisms, Dysnatraemia, and the Clinical Relevance in Adult Critical Illness.Journal of clinical medicine · 2025Review
- Predicting high-risk return at emergency department presentation for patients who undergo short-term revisits: the HANDLE-24 score.BMC emergency medicine · 2025Article
- Optimizing brain protection after cardiac arrest: advanced strategies and best practices.Interface focus · 2024Review
- Sodium and Hematocrit Levels' Correlation and Clinical Impacts in Jordanian Hemodialysis Patients.Cureus · 2024Article
- The Relationship between the Ratio of Urine Osmolality to Serum Osmolality and Neurological Outcomes in Out-of-hospital Cardiac Arrest Patients.Reviews in cardiovascular medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the potential association between early dysnatremia and 6-month functional outcome after cardiac arrest.
methodsWe pooled data from four randomised clinical trials in post-cardiac-arrest patients admitted to the ICU with coma after stable return of spontaneous circulation (ROSC). Admission natremia was categorised as normal (135-145 mmol/L), low, or high. We analysed associations between natremia category and Cerebral Performance Category (CPC) 1 or 2 at 6 months, with and without adjustment on the modified Cardiac Arrest Hospital Prognosis Score (mCAHP).
resultsWe included 1163 patients (581 from HYPERION, 352 from TTH48, 120 from COMACARE, and 110 from Xe-HYPOTHECA) with a mean age of 63 ± 13 years and a predominance of males (72.5%). A cardiac cause was identified in 63.6% of cases. Median time from collapse to ROSC was 20 [15-29] minutes. Overall, mean natremia on ICU admission was 137.5 ± 4.7 mmol/L; 211 (18.6%) and 31 (2.7%) patients had hyponatremia and hypernatremia, respectively. By univariate analysis, CPC 1 or 2 at 6 months was significantly less common in the group with hyponatremia (50/211 [24%] vs. 363/893 [41%]; P = 0.001); the mCAHP-adjusted odds ratio was 0.45 (95%CI 0.26-0.79, p = 0.005). The number of patients with hypernatremia was too small for a meaningful multivariable analysis.
conclusionsEarly hyponatremia was common in patients with ROSC after cardiac arrest and was associated with a poorer 6-month functional outcome. The mechanisms underlying this association remain to be elucidated in order to determine whether interventions targeting hyponatremia are worth investigating. Registration ClinicalTrial.gov, NCT01994772, November 2013, 21.
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