Sodium Imbalance among Post-operative Traumatic Brain Injury Patients: A Descriptive Study

Abstract

Background: Traumatic brain injury (TBI) is the damage to the brain resulting from external mechanical force, such as rapid acceleration or deceleration or penetration by a projectile object. Electrolyte imbalance, especially sodium is very common due to the abnormal biochemical changes which occur after TBI. Nurses should have the knowledge about the changes in electrolyte levels in order to understand the principles of treatment and to prevent common complications in the clinical setting. Aim of the study: To assess the prevalence of sodium imbalance in post-operative patients with TBI. The aim of this study is to evaluate the serum sodium level and its disorders including hypernatremia and hyponatremia in patients with TBI. Methods: A descriptive design was employed, 50 post-operative TBI patients in the age group of 19‑65 years, were enrolled over a period of 2 months. Their serum sodium levels were monitored daily for 6 days and estimated by ion selective electrode method. Results: The mean age of the patients was 35.38±13.0 years, 84% were males and 16% were females in the study. 62% subjects sustain traumatic brain injury due to motor vehicle accident. On admission, 100% of the subjects were in normonatremic state which fell from 100 to 60% till 5th POD. Hypernatremia was seen from 10 to 14% from 1st to 5th POD, whereas hyponatremia rises from 8%, i.e., on 0th to 26% till 5th post-operative day and seen maximum on 3rd POD, i.e., 36%. Conclusion: This study showed the prevalence of the patients with abnormal sodium level is higher, both hypernatremia and hyponatremia are common in the post-operative patients with TBI. In order to prevent the complications, close monitoring and recording of electrolytes are very important.