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Master Thesis

Traitement par urée de l’hyponatrémie au cours des hémorragies sous arachnoïdienne : étude NAT-URE

Abstract : Introduction: Hyponatremia is a frequent complication of Subarachnoid Hemorrhage (ASH), impacting the neurological prognosis. The treatment of hyponatremia must adapt to its etiology: syndrome of inappropriate secretion of antidiuretic hormone (SIADH) or cerebral salt wasting syndrome (CSWS) but the differential diagnosis in intensive care unit is often difficult. Sodium supplementation is used as a first line, but it is insufficient during SIADH. Urea is effective during SIADH with a low risk of complications. The mechanism of action of urea is based on its osmotic diuretic action and its role in sodium reabsorption. ADH plays a fundamental role in volume homeostasis and blood sugar levels. Copeptin, its surrogate marker is a promising etiological marker for hyponatremia. Method: We designed a prospective study, randomized, controlled, double-blind treatment of urea versus placebo for hyponatremia in patients hospitalized for HAS in neurosurgical intensive care unit at the Grenoble Alpes Hospital Center. We will study the correction of the serum at the end of the treatment. Copeptin will be dosed during treatment to look for an effect relating to the regulation of ADH. Result: According to our starting hypothesis, 52 subjects are necessary. The prevalence of hyponatremia in the service is 34% out of an average of 107 patients hospitalized per year for an ASH. Inclusions will take 2 years. Conclusion: This study could allow the integration of urea treatment into the management of hyponatremia during HSA.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03469185
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Tuesday, December 7, 2021 - 3:16:24 PM
Last modification on : Saturday, January 1, 2022 - 3:33:23 AM

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  • HAL Id : dumas-03469185, version 1
  • PPN : 245359303

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Anne-Gaëlle Dacre Wright. Traitement par urée de l’hyponatrémie au cours des hémorragies sous arachnoïdienne : étude NAT-URE. Médecine humaine et pathologie. 2020. ⟨dumas-03469185⟩

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