بررسی میزان سدیم،پتاسیم و اسمولاریته پلاسما در بیماران ضربه مغزی در بخش مراقبت‌های ویژه اعصاب

The main goals of fluid therapy in brain edema include: maintenance of perfusion pressure, prevention of extreme osmolarity changes and hyperglycemia. In some studies, monitol has increased plasma osmolarity and decreased brain water content in dose related. Another research showed that hypertonic saline has led to decrease ICP because of its osmotic effect .Plasma Na, K are related parameters of osmolarity. This study was performed to assess serum sodium, potassium and osmolarity in head injury severities. Materials and Methods: In this prospective experimental – observational study, fity seven patients admitted to neurosurgery ICU were investigated . GCS and serum Na, K were checked at 6 am daily for 4 days. The serum osmolarity was calculated with formula(osm = 2Na + BuN/2.8 + G/18 ). The patients were divided into 3 and 4 groups based on GCS and day of hospitalization. In each 24 hours, there were GCS= 13-15 as mild, GCS =9-12 as moderate and GCS ≤ 8 as severe groups of head injury. Then the data were analyzed statistically. Results: Number of patients, from severe to mild head injury decreased during 4 days. For mean osmolarity there was significant difference between moderate, compared with mild and severe groups (p = 0/03)There was no significant difference for mean serum electrolytes among all groups. Conclusion: There were no relationship between mean serum osmolarity, electrolytes and GCS,which may indictes influence of other therapies on osmolarity,ABG condition, patients’positioning and temperature, need to mechanical ventilation, and staying blood samples in laboratory environment