{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T19:45:36Z","timestamp":1776282336533,"version":"3.50.1"},"reference-count":0,"publisher":"California Digital Library (CDL)","issue":"2","license":[{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Practice and Cases in Emergency Medicine"],"abstract":"<p>Introduction: Severe hypernatremia is a critical situation, and when coupled with intravascular depletion and hypotension can create a treatment dilemma.Case Report: 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.Conclusion: Final diagnoses included severe hypernatremia and hypovolemic shock secondary to poor oral intake. We used judicious \ufb02uid 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 \ufb02uid resuscitation can be a challenging situation for the multidisciplinary team.<\/p>","DOI":"10.5811\/cpcem.1422","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T14:29:44Z","timestamp":1709648984000},"source":"Crossref","is-referenced-by-count":0,"title":["Permissive Hypotension in a Patient with Severe Hypernatremia: A Case Report"],"prefix":"10.5811","volume":"8","author":[{"given":"Andrea","family":"Hlady","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Kerner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1127-327X","authenticated-orcid":false,"given":"Laura","family":"Walker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2024,3,5]]},"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"link":[{"URL":"https:\/\/escholarship.org\/content\/qt2sb3g41z\/qt2sb3g41z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T18:53:34Z","timestamp":1776279214000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/2sb3g41z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,5]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,5,16]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.1422","relation":{},"ISSN":["2474-252X"],"issn-type":[{"value":"2474-252X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,5]]}}}