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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2024; 43(01): e40-e47
DOI: 10.1055/s-0043-1774749
Review Article

The Role of Sodium and Glucose in the Prognosis of Patients with Aneurysmal Subarachnoid Hemorrhage: A Literature Review of New Evidence

O papel do sódio e da glicose no prognóstico de pacientes com hemorragia subaracnóidea aneurismática: Uma revisão de literatura das novas evidências
Zeferino Campos Dell'Orto 
1   Medicine Department, Universidade Federal de Juiz de Fora, Campus Governador Valadares, MG, Brazil
,
Isadora Valério da Silveira 
1   Medicine Department, Universidade Federal de Juiz de Fora, Campus Governador Valadares, MG, Brazil
,
Larissa da Silva Torres França 
1   Medicine Department, Universidade Federal de Juiz de Fora, Campus Governador Valadares, MG, Brazil
,
Murillo Sampaio Ferreira Medeiros 
1   Medicine Department, Universidade Federal de Juiz de Fora, Campus Governador Valadares, MG, Brazil
,
Talita Cardoso Gomes 
1   Medicine Department, Universidade Federal de Juiz de Fora, Campus Governador Valadares, MG, Brazil
,
Bruno Alves Pinto 
1   Medicine Department, Universidade Federal de Juiz de Fora, Campus Governador Valadares, MG, Brazil
,
Daniel Gonçalves de Oliveira 
1   Medicine Department, Universidade Federal de Juiz de Fora, Campus Governador Valadares, MG, Brazil
,
Gabryell Thiengo Lopes
1   Medicine Department, Universidade Federal de Juiz de Fora, Campus Governador Valadares, MG, Brazil
,
Ivan Magalhães Viana
1   Medicine Department, Universidade Federal de Juiz de Fora, Campus Governador Valadares, MG, Brazil
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Abstract

The present study aims to review the influence of glycemia and natremia on the propensity to develop complications, worse prognosis, and mortality risk in patients with aneurysmal subarachnoid hemorrhage (aSAH). This is an integrative literature review guided by the guiding question: “Do changes in blood glucose levels or plasma sodium concentration influence in-hospital morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage?”. The search for articles was performed on the PubMed platform, limiting the selection to works published in English in the period from 2017 to 2022. The results found demonstrate that the role of sodium ions in changes in the prognosis of patients is complex, with hypernatremia being the main factor described to worse outcomes. In contrast, the part of hyponatremia is controversial and may not have prognostic value, and serum sodium concentration is increasingly an important item to be evaluated in patients with aSAH. As for glucose, the variability of this substrate, both hyperglycemia and hypoglycemia, may be correlated with in-hospital and long-term mortality in patients with aSAH. Thus, the present study concludes that changes in blood glucose values and plasma sodium concentration influence the in-hospital morbidity and mortality of patients with aSAH. However, it is emphasized that the analysis of the independent influence of each of the related predictors must be done with caution due to the heterogeneity of the results found.

Resumo

O presente estudo tem como objetivo a revisão da influência da glicemia e da natremia na propensão ao desenvolvimento de complicações, no pior prognóstico e no risco de mortalidade em pacientes com hemorragia subaracnóidea aneurismática (HSAa). Trata-se de uma revisão integrativa de literatura guiada pela questão norteadora: “Alterações nos valores da glicemia ou concentração de sódio plasmática influenciam na morbimortalidade intrahospitalar de pacientes com hemorragia subaracnóidea aneurismática?”. A busca de artigos foi realizada na plataforma PubMed, limitando a seleção para trabalhos publicados em língua inglesa no período de 2017 a 2022. Os resultados encontrados demonstram que o papel do íon sódio nas alterações no prognóstico dos pacientes é complexo, sendo a hipernatremia o principal fator descrito em relação a piores desfechos, enquanto o papel da hiponatremia é controverso e pode não ter valor prognóstico, e a concentração de sódio sérica apresenta-se cada vez mais como um item importante a ser avaliado no paciente com HSAa. Já quanto à glicose, a variabilidade desse substrato, tanto a hiperglicemia como também a hipoglicemia, pode estar correlacionada com a mortalidade hospitalar e a longo prazo em pacientes com HSAa. Assim, o presente estudo conclui que as alterações nos valores de glicemia e concentração de sódio plasmático têm influência na morbimortalidade intrahospitalar dos pacientes com HSAa. Entretanto, ressalta-se que a análise da influência independente de cada um dos preditores relacionados deve ser feita com cautela devido à heterogeneidade dos resultados encontrados.

Keywords

neurosurgery - hemorrhagic stroke - intracranial aneurysm

Palavras-chave

neurocirurgia - acidente vascular cerebral hemorrágico - aneurisma intracraniano


Publication History

Received: 30 January 2023

Accepted: 04 August 2023

Article published online:
10 October 2023

© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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