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{
    "pk": 1422,
    "title": "Permissive Hypotension in a Patient with Severe Hypernatremia: A Case Report",
    "subtitle": null,
    "abstract": "<b>Introduction:</b> Severe hypernatremia is a critical situation, and when coupled with intravascular depletion and hypotension can create a treatment dilemma.<p></p><p><b>Case Report:</b> We present the case of a medically complex patient who had gradually worsening alteration of mental status and mean arterial pressures in the 50s on presentation to the emergency department.</p><p></p><p><b>Conclusion:</b> Final diagnoses included severe hypernatremia and hypovolemic shock secondary to poor oral intake. We used judicious fluid repletion with gradual improvement in sodium levels and permissive hypotension to avoid rapid osmotic shifts. Balancing reperfusion and the risk for osmotic effects of aggressive fluid resuscitation can be a challenging situation for the multidisciplinary team.</p>",
    "language": "eng",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "hypernatremia"
        },
        {
            "word": "permissive hypotension"
        },
        {
            "word": "dehydration"
        },
        {
            "word": "metabolic disturbance"
        },
        {
            "word": "case report"
        }
    ],
    "section": "Case Reports",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/2sb3g41z",
    "frozenauthors": [
        {
            "first_name": "Andrea",
            "middle_name": "",
            "last_name": "Hlady",
            "name_suffix": "",
            "institution": "Mayo Clinic Health System, Department of Emergency Medicine, Alberta Lea, Minnesota",
            "department": "Emergency Medicine"
        },
        {
            "first_name": "David",
            "middle_name": "",
            "last_name": "Kerner",
            "name_suffix": "",
            "institution": "Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota",
            "department": "Emergency Medicine"
        },
        {
            "first_name": "Laura",
            "middle_name": "",
            "last_name": "Walker",
            "name_suffix": "",
            "institution": "Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota",
            "department": ""
        }
    ],
    "date_submitted": "2023-05-31T16:00:47.932000-04:00",
    "date_accepted": "2023-10-13T18:03:48.034000-03:00",
    "date_published": "2024-03-05T11:00:00-03:00",
    "render_galley": {
        "label": "Final Article",
        "type": "pdf",
        "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1422/galley/10106/download/"
    },
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            "label": "Layout",
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            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1422/galley/3819/download/"
        },
        {
            "label": "Final Article",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1422/galley/10106/download/"
        }
    ]
}