Â鶹´«Ã½Ó³»­

Â鶹´«Ã½Ó³»­

Explore the latest content from across our publications
Join The Â鶹´«Ã½Ó³»­

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

The Effect of Serum Sodium Level on Brain Edema after Intracerebral Hemorrhage
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
083
The primary objective is to determine the association of hypernatremia (serum sodium >145) with peri-hematoma edema and midline shift in patients with nontraumatic intracerebral hemorrhage (ICH).
The use of osmotic agents, such as hypertonic saline (HTS), to manage intracerebral edema and elevated intracranial pressure (ICP) has been well-studied. As such, maintaining hypernatremia in the acute period after ICH has been applied as a method to minimize edema and mitigate elevated ICP. Our post-hoc analysis explores the usefulness of hypernatremia for mitigating brain edema after non-traumatic ICH.
Our analytic sample was derived from ATACH-II and included 920 individuals after removing 70 individuals with missing data. The primary exposure was the mean of serum sodium measurements performed at baseline and 24 hours. Secondary exposures were baseline sodium level, the difference between baseline and 24-hour sodium, and the clinical cutpoint of sodium >145 at baseline and 24-hours. Outcomes were change in midline shift and peri-hematoma edema from baseline to 24 hours. Cube roots were applied to outcomes to mitigate skew. The confounder set was determined a-priori, and then narrowed using stepwise backward selection for each model, but all models included volume (mL) of the intraparenchymal and ventricular hemorrhage. Linear regressions were used to determine associations.
After adjustment for confounders, there was no statistically significant association between mean sodium with midline shift at 24 hours (BNa 0.007; 95% CI: -0.004 to 0.019) or with edema volume at 24 hours (BNa 0.003; 95% CI: -0.003 to 0.009).  These null associations persisted when using secondary exposures to model sodium.
Hypernatremia after non-traumatic ICH does not appear to significantly affect peri-hematoma edema or midline shift in the initial 24 hours after hospital admission.
Authors/Disclosures
Rachel J. Saban, MD (University of Colorado School of Medicine)
PRESENTER 		Dr. Saban has nothing to disclose.
Eric Stulberg, MD (University of Utah) Dr. Stulberg has nothing to disclose.
No disclosure on file
Adam De Havenon, MD, FÂ鶹´«Ã½Ó³»­ (Yale University) Dr. De Havenon has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novo Nordisk. Dr. De Havenon has or had stock in Certus.Dr. De Havenon has or had stock in TitinKM. The institution of Dr. De Havenon has received research support from NIH/NINDS. Dr. De Havenon has received publishing royalties from a publication relating to health care.