Severe Hyponatremia Management with DDAVP Clamp-Bolus Technique

Severe Hyponatremia Management with DDAVP Clamp-Bolus Technique

The DDAVP clamp technique has considerably simplified the management of severe hyponatremia. The DDAVP clamp was a substantial step forwards in the management of severe hyponatremia. It eliminated a lot of the variability... read more

Serum Sodium and In-Hospital Mortality in Critically Ill Patients

Serum Sodium and In-Hospital Mortality in Critically Ill Patients

In this large multicenter observational cohort study of ICU patients, we aimed to assess the independent association of changes in serum sodium in the first 48 hours of ICU admission with in-hospital mortality for patients... read more

Effect of Out-of-Hospital Sodium Nitrite on Survival to Hospital Admission After Cardiac Arrest

Effect of Out-of-Hospital Sodium Nitrite on Survival to Hospital Admission After Cardiac Arrest

Among patients with out-of-hospital cardiac arrest, administration of sodium nitrite, compared with placebo, did not significantly improve survival to hospital admission. These findings do not support the use of sodium nitrite... read more

Hypertonic vs. Hypotonic, Osmolality, and Other Fun Nursing Concepts

Hypertonic vs. Hypotonic, Osmolality, and Other Fun Nursing Concepts

The basic concepts underlying the body's mechanisms for keeping systems functioning are complex processes involving the ebb and flow of fluid and molecules controlled by several systems. It is a delicate balance and one... read more

Serum Chloride Levels in Critical Illness – The Hidden Story

Serum Chloride Levels in Critical Illness – The Hidden Story

Chloride is the principal anion of the extracellular fluid and vital for both serum electroneutrality and acid-base homeostasis. The aim of this review is to investigate the relevance of dyschloremia in the critically... read more

The Poor Man’s Tox Screen: ECG Findings in the Acute Overdose

The Poor Man’s Tox Screen: ECG Findings in the Acute Overdose

In the middle of a busy ED shift the tech runs up to you with an ECG. Just prior to signing the top "No STEMI" you think: "wait, why do the QRS complexes look like that?" You walk back to triage with the tech to see a... read more

Sodium Bicarbonate Therapy for Patients with Severe Metabolic Acidaemia in the ICU

Sodium Bicarbonate Therapy for Patients with Severe Metabolic Acidaemia in the ICU

In patients with severe metabolic acidaemia, sodium bicarbonate had no effect on the primary composite outcome. However, sodium bicarbonate decreased the primary composite outcome and day 28 mortality in the a-priori defined... read more

Abnormal Saline and the History of Intravenous Fluids

Abnormal Saline and the History of Intravenous Fluids

Two new clinical trials together involving nearly 30,000 patients support previous observational evidence that the most common solution used for intravenous fluid therapy in the world is associated with kidney damage. Both... read more

Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine

Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine

Intravenous sodium bicarbonate and oral acetylcysteine are widely used to prevent acute kidney injury (AKI) and associated adverse outcomes after angiography without definitive evidence of their efficacy. Among patients at... read more

Therapeutic Interchange of Clevidipine For Sodium Nitroprusside in Cardiac Surgery

Therapeutic Interchange of Clevidipine For Sodium Nitroprusside in Cardiac Surgery

Sodium nitroprusside (SNP) has been used clinically for decades for the treatment of hypertension associated with cardiac surgery.... read more

Sodium Bicarbonate Versus Sodium Chloride for Preventing Contrast-Associated AKI

Sodium Bicarbonate Versus Sodium Chloride for Preventing Contrast-Associated AKI

Except for urinary pH, none of the outcomes differed between the two groups. Among ICU patients with stable renal function, the benefit of using sodium bicarbonate rather than isotonic sodium chloride for preventing contrast-associated... read more

Association of Sodium Selenite and Procalcitonin-Guided Therapy With Mortality

Association of Sodium Selenite and Procalcitonin-Guided Therapy With Mortality

This randomized clinical trial evaluates the use of high-dose sodium selenite, with or without use of a procalcitonin algorithm to guide therapy, and its association with mortality in patients with severe sepsis.... read more