Serum Osmolality in Acutely Injured Patients.
Technical rept. Jan-May 74,
EDGEWOOD ARSENAL ABERDEEN PROVING GROUND MD
Pagination or Media Count:
The study was to determine the etiology and to evaluate the prognostic significance of serum hyperosmolality in acutely injured patients. The case histories of 700 patients admitted to the Maryland Institute for Emergency Medicine were examined, and those of 72 patients with serum hyperosmolalities greater than 340 mOsmkg were selected for this retrospective study. Of the group selected, 12.5 survived and 87.5 expired. The hyperosmolar state in 56 of the survivors resulted from their therapy hyperalimentation or mannitol infusion. Of those that died, 79 had kidney failure and 11 had central nervous system injury. The main determinant of prognosis when hyperosmolality is present is organ system failure particularly the kidney. If hyperosmolality is associated with renal failure, the prognosis is poor. As hyperosmolality in a patient without major organ system dysfunction is frequently a complication of therapy, it is usually reversible. Therefore, the serum osmolality of all patients on hyperalimentation or steroids should be followed carefully and frequently. Author
- Stress Physiology