低钠血症诊疗指南.ppt

低钠血症诊疗指南
第一页，共25页。
2014 欧洲低钠血症诊疗指南
欧洲危重病学会（ESICM），
欧洲内分泌学会（ESE）
欧洲肾脏病协会（欧洲肾脏最佳临床实践European Renal Best Practice ERt . infusion of 150 ml 3% hypertonic over 20 min (1D).
. We suggest checking the serum sodium concentration after 20 min while repeating an infusion of 150 ml 3% hypertonic saline for the next 20 min (2D).
. We suggest repeating and twice or until a target of 5 mmol/l increase in serum sodium concentration is achieved(2D).
. Manage patients with severely symptomatic hyponatraemia in an environment where close biochemicaland clinical monitoring can be provided (not graded).
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推荐立即静脉输注3%高渗盐水150ml,速度20分钟以上 （1D）
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20分钟后检查血钠浓度并在第二个20分钟重复静脉输注3%高渗盐水150ml （2D）
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建议重复以上治疗推荐两次或直到达到血钠浓度增加5mmol/L (2D)
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应该在具有密切生化和临床监测的环境下对有严重症状的低钠血症患者进行治疗
第九页，共25页。
1小时后血钠 5 mmol/L,症状改善的接续治疗
. We recommend stopping the infusion of hypertonic saline (1D).
. We recommend keeping the . line open by infusing the smallest feasible volume of % saline until cause-specific treatment is started (1D).
. We recommend starting a diagnosis-specific treatment if available, aiming at least to stabilise sodium concentration (1D).
. We recommend limiting the increase in serum sodium concentration to a total of 10 mmol/l during the first 24 h and an additional 8 mmol/l during every 24 h thereafter until the serum sodium concentration reaches 130 mmol/l (1D).
. We suggest checking the serum sodium concentration after 6 and 12 h and daily afterwards until the serum sodium concentration has stabilised under stable treatment (2D).
：推荐停止输注高渗盐水（1D）
：保持静脉通道通畅，%盐水直到开始针对病因治疗（1D）
：如果可能开始特异性诊断治疗，但至少是血钠浓度稳定（1D）
：第1个24h限制血钠升高超过10ml，随后每24h血钠升高<8mmol. 直到血钠达到130mmol/l
: 第6h,12h复查血钠，此后每天复查，直到血钠浓度稳定
第十页，共25页。
1小时后，血钠 5mmol/l，但症状无改善
. We recommend continuing an . infusion of 3%hypertonic