A 50-year-old man on ICU has severe burns (40% TBSA). On day 3 of resuscitation, he develops a serum sodium of 155 mmol/L, chloride 128 mmol/L, and ur...

Question

A 50-year-old man on ICU has severe burns (40% TBSA). On day 3 of resuscitation, he develops a serum sodium of 155 mmol/L, chloride 128 mmol/L, and urea 25 mmol/L. Urine output has been adequate (1 mL/kg/hr). What is the most likely cause of hypernatraemia?

Accepted Answer

Evaporative free water losses through the burn wound combined with large-volume 0.9% saline resuscitation (Na 154, Cl 154 mmol/L) causing hypernatraemia and hyperchloraemia

Answer

Diabetes insipidus

Answer

Adrenal insufficiency

Answer

Excessive oral salt intake

Answer

Chronic kidney disease

uk-fficm MCQ (SBA): Hypernatraemia in Burns

A 50-year-old man on ICU has severe burns (40% TBSA). On day 3 of resuscitation, he develops a serum sodium of 155 mmol/L, chloride 128 mmol/L, and urea 25 mmol/L. Urine output has been adequate (1 mL/kg/hr). What is the most likely cause of hypernatraemia?