Sodium paʻakai haʻahaʻa

ʻO ke kōkōkō koko haʻahaʻa kahi ʻano i ʻoi aku ka nui o ka sodium ma ke koko ma mua o ka maʻamau. ʻO ka inoa olakino o kēia ʻano he hyponatremia.

Loaʻa ka nui o ka sodium i ka wai o ke kino ma waho o nā hunaola. ʻO Sodium kahi electrolyte (mineral). He mea nui ia no ka mālama ʻana i ke koko.Pono pū kekahi i ka sodium no nā ʻalolo, nā mākala, a me nā kino o ke kino e hana pono.

Ke hāʻule ka nui o ka sodium i nā wai i waho o nā hunaola ma lalo o ka maʻamau, neʻe ka wai i loko o nā pūnaewele e kaulike i nā pae. ʻO kēia ke kumu e pehu ai nā hunaola me ka nui o ka wai. ʻIke nui nā hunaola o ka lolo i ka pehu, a ʻo kēia ke kumu o nā ʻōuli o ka sodium haʻahaʻa.

Me ka sodium koko haʻahaʻa (hyponatremia), hoʻokumu ʻia ke kaulike ʻole o ka wai i ka sodium e kekahi o nā kūlana ʻekolu.

• Euvolemic hyponatremia - piʻi ka nui o ka wai o ke kino, akā noho mau ka paʻakai sodium o ke kino
• Hypervolemic hyponatremia - ʻo ka sodium a me ka wai i loko o ke kino e hoʻonui, akā ʻoi aku ka nui o ka loaʻa o ka wai
• Hypovolemic hyponatremia - nalowale pū ka wai a me ka sodium mai ke kino, akā ʻoi aku ka nui o ka make sodium

Hiki ke hoʻokumu ʻia ka sodium sodium haʻahaʻa e:

• ʻO nā lapalapa e hoʻopili i kahi ākea o ke kino
• Pohā
• Nā lāʻau diuretic (nā wai wai), e hoʻonui ai i ka mimi a me ka lilo ʻana o ka sodium ma o ka mimi
• Hewa puʻuwai
• Nā maʻi kīwī
• Kaʻu cirrhosis
• Syndrome o ke kūpono o ka hunaone antidiuretic hormone (SIADH)
• Hoʻoulu
• ʻO ka luaʻi

ʻO nā ʻōuli maʻamau ka:

• Huikau, huhū, hoʻomaha ʻole
• Nā manaʻo hoʻohoka
• Ka luhi
• ʻEha poʻo
• Loaʻa ka ʻai ʻole
• Ka nāwaliwali o ka mākala, spasms, a i ʻole ke ʻūlū
• Nualea, luaʻi

E hana ka mea mālama ola i kahi hoʻokolokolo kino piha a nīnau e pili ana i kāu mau hōʻailona. E hana ʻia nā hoʻokolohua koko a me ka mimi.

Hiki i nā hoʻokolohua lab ke hōʻoia a kōkua i ka diagnose haʻahaʻa sodium me:

• Pākuʻi metabolic piha (me ka sodium sodium, ʻo ka palena maʻamau ʻo 135 a 145 mEq / L, a ʻo 135 a 145 mmol / L)
• Hōʻike koko Osmolality
• ʻO osmolality mimi
• ʻO ka sodium miki (ʻo ka pae maʻamau he 20 mEq / L i kahi mimi mikiʻala maʻamau, a 40 a 220 mEq i kēlā me kēia lā no kahi hōʻike mimi he 24 mau hola)

ʻO ke kumu o ka sodium haʻahaʻa e pono e ʻike ʻia a mālama ʻia. Inā ʻo ke kanesa ke kumu o ke ʻano, a laila radiation, chemotherapy, a i ʻole ke ʻoki ʻana e kāpae i ka tumo e hoʻoponopono i ke kaulike ʻole o ka sodium.

Pili nā mālama ʻē aʻe i ke ʻano kikoʻī o hyponatremia.

Hiki i nā mālama ke hoʻopili:

• Nā Fluids ma o kahi aa (IV)
• Nā lāʻau lapaʻau e hōʻoluʻolu i nā ʻōuli
• Ka palena ʻana i ka lawe ʻana o ka wai

Aia ka hopena i ke ʻano o ka pilikia. ʻO ka sodium haʻahaʻa e kū ma lalo o 48 mau hola (hyponatremia ākea), ʻoi aku ka weliweli ma mua o ka sodium haʻahaʻa e ulu lohi ana i ka manawa. Ke hāʻule mālie ka pae sodium i nā lā a i ʻole mau pule (hyponatremia maʻi mau), loaʻa ka manawa o nā keena lolo e hoʻoponopono a liʻiliʻi paha ka pehu.

I nā hihia koʻikoʻi, hiki i ka sodium haʻahaʻa ke alakaʻi i:

• Hoemi i ka ʻike, nā hiʻohina a me ke koma
• Herniation lolo
• Make

Ke hāʻule nui ka pae sodium o kou kino, hiki ke lilo i kahi ola weliweli. Kāhea koke i kāu mea hāʻawi inā loaʻa iā ʻoe nā ʻōuli o kēia ʻano.

Hiki ke kōkua i ka mālama ʻana i ke ʻano e hōʻemi ana i ka sodium haʻahaʻa.

Inā pāʻani ʻoe i nā haʻuki a hana paha i kahi hana ikaika ʻē aʻe, inu i nā wai e like me nā inu haʻuki i loaʻa nā electrolytes e mālama i ka pae sodium o kou kino i kahi papa olakino.

Hyponatremia; Dilonic hyponatremia; Hyponatremia Euvolemic; Hyponatremia Hypervolemic; Hypovolemic hyponatremia

ʻO Dineen R, Hannon MJ, Thompson CJ. Hyponatremia a me hypernatremia. I: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Makua a Pediatric. ʻEpekema 7 Piladelapia, PA: Elsevier Saunders; 2016: chap 112.

Nā pilikia pōkole M. Metabolic. I: Cameron P, Jelinek G, Kelly A-M, Brown A, Little M, eds. Puka o ka Medicine Emergency Emergency. ʻEhā ed. Piladelapia, PA: Elsevier; 2015: paukū 12.