Linezolid-associated Hyponatremia in Section Guillain-Barré Syndrome Patients in Intensive Care unit: A Retrospective Analysis
Introduction: Guillain-Barré Syndrome (GBS) is a neurological disorder associated with ascending paralysis due to damage to the peripheral nerves by the immune system. Hyponatremia is the most common electrolyte disorder encountered in patients with GBS admitted to the Neurointensive Care Unit (...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2023-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/18793/66003_CE[Ra1]_F(IS)_QC(RD_RDW_IS)_PF1(AKA_OM)_redo_PFA(NC_OM)_PN(OM).pdf |
| _version_ | 1827585631824379904 |
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| author | Shweta Suresh Naik Mathangi Krishnakumar S Mouleeswaran VJ Ramesh |
| author_facet | Shweta Suresh Naik Mathangi Krishnakumar S Mouleeswaran VJ Ramesh |
| author_sort | Shweta Suresh Naik |
| collection | DOAJ |
| description | Introduction: Guillain-Barré Syndrome (GBS) is a neurological
disorder associated with ascending paralysis due to damage to
the peripheral nerves by the immune system. Hyponatremia is
the most common electrolyte disorder encountered in patients
with GBS admitted to the Neurointensive Care Unit (NICU).
Hyponatremia is associated with a poor outcome, prolonged
hospital stay, and increased hospital cost. Linezolid is an
oxazolidinone antibiotic used against gram-positive bacteria.
The main adverse effect limiting its use is the development of
myelo suppression; however, it can also cause hyponatremia.
Aim: To investigate the incidence of hyponatremia in GBS
patients treated with linezolid.
Materials and Methods: This was a retrospective study
conducted in a 14-bedded NICU at the National Institute of
Mental Health and Neurosciences, Bengaluru, Karnataka, India,
over a period from January 2017 to January 2018. All patients
with GBS who received linezolid therapy were included in the
study. Out of 46 admitted patients, 16 received linezolid therapy.
Final data were available for 12 patients. Hyponatremia was
defined as sodium <134 mmol/L, and severe hyponatremia was
defined as sodium <128 mmol/L. Descriptive statistics were
used to characterise the data. The Wilcoxon signed-rank test
was used to compare sodium levels before and after linezolid
therapy. A p-value <0.05 was considered significant.
Results: The incidence of hyponatremia was 9 out of 12 (75%).
Five out of 12 patients had severe hyponatremia. There was
a significant decrease of 11 (7-12) mmol/L in sodium level
before and after linezolid therapy (p<0.001). The median days
to develop hyponatremia were 3 (2-4) days after initiation of
therapy. No mortality was observed in the study population.
Conclusion: The incidence of hyponatremia is high in GBS
patients treated with linezolid in the NICU. It is imperative to
monitor sodium levels at frequent intervals in patients treated
with linezolid to recognise and treat hyponatremia. |
| first_indexed | 2024-03-08T23:49:23Z |
| format | Article |
| id | doaj.art-07bea7d50bf04aa6be7b8c23761c640f |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-03-08T23:49:23Z |
| publishDate | 2023-12-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-07bea7d50bf04aa6be7b8c23761c640f2023-12-13T12:14:55ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-12-011712060910.7860/JCDR/2023/66003.18793Linezolid-associated Hyponatremia in Section Guillain-Barré Syndrome Patients in Intensive Care unit: A Retrospective AnalysisShweta Suresh Naik0Mathangi Krishnakumar1S Mouleeswaran2VJ Ramesh3Assistant Professor, Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.Assistant Professor, Department of Anaesthesia, St John’s Medical College Hospital, Bengaluru, Karnataka, India.Assistant Professor, Department of Anesthesiology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra, India.Professor, Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.Introduction: Guillain-Barré Syndrome (GBS) is a neurological disorder associated with ascending paralysis due to damage to the peripheral nerves by the immune system. Hyponatremia is the most common electrolyte disorder encountered in patients with GBS admitted to the Neurointensive Care Unit (NICU). Hyponatremia is associated with a poor outcome, prolonged hospital stay, and increased hospital cost. Linezolid is an oxazolidinone antibiotic used against gram-positive bacteria. The main adverse effect limiting its use is the development of myelo suppression; however, it can also cause hyponatremia. Aim: To investigate the incidence of hyponatremia in GBS patients treated with linezolid. Materials and Methods: This was a retrospective study conducted in a 14-bedded NICU at the National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India, over a period from January 2017 to January 2018. All patients with GBS who received linezolid therapy were included in the study. Out of 46 admitted patients, 16 received linezolid therapy. Final data were available for 12 patients. Hyponatremia was defined as sodium <134 mmol/L, and severe hyponatremia was defined as sodium <128 mmol/L. Descriptive statistics were used to characterise the data. The Wilcoxon signed-rank test was used to compare sodium levels before and after linezolid therapy. A p-value <0.05 was considered significant. Results: The incidence of hyponatremia was 9 out of 12 (75%). Five out of 12 patients had severe hyponatremia. There was a significant decrease of 11 (7-12) mmol/L in sodium level before and after linezolid therapy (p<0.001). The median days to develop hyponatremia were 3 (2-4) days after initiation of therapy. No mortality was observed in the study population. Conclusion: The incidence of hyponatremia is high in GBS patients treated with linezolid in the NICU. It is imperative to monitor sodium levels at frequent intervals in patients treated with linezolid to recognise and treat hyponatremia.https://www.jcdr.net/articles/PDF/18793/66003_CE[Ra1]_F(IS)_QC(RD_RDW_IS)_PF1(AKA_OM)_redo_PFA(NC_OM)_PN(OM).pdfantibioticneurological disorderoxazolidinone |
| spellingShingle | Shweta Suresh Naik Mathangi Krishnakumar S Mouleeswaran VJ Ramesh Linezolid-associated Hyponatremia in Section Guillain-Barré Syndrome Patients in Intensive Care unit: A Retrospective Analysis Journal of Clinical and Diagnostic Research antibiotic neurological disorder oxazolidinone |
| title | Linezolid-associated Hyponatremia in Section Guillain-Barré Syndrome Patients in Intensive Care unit: A Retrospective Analysis |
| title_full | Linezolid-associated Hyponatremia in Section Guillain-Barré Syndrome Patients in Intensive Care unit: A Retrospective Analysis |
| title_fullStr | Linezolid-associated Hyponatremia in Section Guillain-Barré Syndrome Patients in Intensive Care unit: A Retrospective Analysis |
| title_full_unstemmed | Linezolid-associated Hyponatremia in Section Guillain-Barré Syndrome Patients in Intensive Care unit: A Retrospective Analysis |
| title_short | Linezolid-associated Hyponatremia in Section Guillain-Barré Syndrome Patients in Intensive Care unit: A Retrospective Analysis |
| title_sort | linezolid associated hyponatremia in section guillain barre syndrome patients in intensive care unit a retrospective analysis |
| topic | antibiotic neurological disorder oxazolidinone |
| url | https://www.jcdr.net/articles/PDF/18793/66003_CE[Ra1]_F(IS)_QC(RD_RDW_IS)_PF1(AKA_OM)_redo_PFA(NC_OM)_PN(OM).pdf |
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