Zusammenfassung
Ob in der Notaufnahme, in der Klinik oder in der Hausarztpraxis, die Hyponatriämie ist ein fächerübergreifendes Problem, mit dem jeder Arzt regelmäßig konfrontiert wird. Diagnostik und Therapie dieser häufigen Elektrolytstörung sind komplex, allgemeingültige Empfehlungen sind mangels evidenzbasierter Daten nicht in Aussicht. Damit die Patientenversorgung nicht zur Glaubensfrage zwischen teilweise widersprüchlichen Leitlinien wird, ist es für den Kliniker sinnvoll, sich mit ein paar wenigen Grundprinzipien der Wasserregulationsstörungen selbst vertraut zu machen und im Einzelfall die Therapiemaxime „Sicherheit geht vor“ zu beachten und umzusetzen.
Abstract
Hyponatremia is the most common electrolyte disorder in clinical practice and associated with increased morbidity and mortality, independent of underlying disease. Untreated acute hyponatremia can cause substantial morbidity and mortality as a result of osmotically induced cerebral edema whilst over rapid correction of chronic hyponatremia can cause serious neurologic impairment and death resulting from osmotic demyelination. Still hyponatremia is often neglected and insufficiently addressed, most likely due to limited understanding of its pathophysiological mechanisms. Being familiar with only few basic principles of body fluid regulation may be a worthwhile investment into the clinical career and save patients’ lives.
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H. Lehnert, Lübeck
M. Reincke, München
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Fenske, W. Hyponatriämie in der Notaufnahme – häufig gefährlich. Internist 58, 1042–1052 (2017). https://doi.org/10.1007/s00108-017-0315-z
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DOI: https://doi.org/10.1007/s00108-017-0315-z
Schlüsselwörter
- Syndrom der inadäquaten Sekretion von antidiuretischem Hormon (SIADH)
- Hypertone Kochsalzlösung
- Tolvaptan
- Leitlinien
- Neurologische Symptomatik