Free
Correspondence  |   April 2001
Abnormal Serum Sodium and Chloride Concentrations May Contribute to Cognitive Dysfunction during Severe Isovolemic Anemia
Author Notes
  • Allegheny General Hospital, Pittsburgh, Pennsylvania. ewilliam@wpahs.org
Article Information
Correspondence
Correspondence   |   April 2001
Abnormal Serum Sodium and Chloride Concentrations May Contribute to Cognitive Dysfunction during Severe Isovolemic Anemia
Anesthesiology 4 2001, Vol.94, 716. doi:
Anesthesiology 4 2001, Vol.94, 716. doi:
To the Editor:—
I read the article by Dr. Weiskopf et al.  1 with great interest. Their published data lead one to the conclusion that severe anemia adversely affects cognitive function. However, I propose that concurrent changes in serum sodium or chloride concentrations possibly could have contributed to this change in cognitive function.
During a volunteer study of serum osmolality, 2 we made the unexpected observation of vague subjective decreases of cognitive function after infusions of 0.9% sodium chloride but not lactated Ringer’s solution. We did not quantify the cognitive dysfunction because it only became apparent after we reviewed the comments of the volunteers who were blinded to the nature of the intravenous infusion.
In the study of Dr. Weiskopf et al.  , 1 5% human albumin (which is dissolved in 0.9% sodium chloride) was administered in addition to the subject’s plasma to maintain isovolemia. Therefore, the subjects could have had increased serum chloride or sodium concentrations when they were severely anemic and demonstrating cognitive dysfunction. It would be interesting to know the values of these serum electrolyte concentrations during their study and whether there was a correlation with cognitive function change.
Allegheny General Hospital, Pittsburgh, Pennsylvania. ewilliam@wpahs.org
References
Weiskopf RB, Kramer JH, Viele M, Neumann M, Feiner JR, Watson JJ, Hopf HW, Toy P: Acute severe isovolemic anemia impairs cognitive function and memory in humans. A nesthesiology 2000; 92: 1646–52Weiskopf, RB Kramer, JH Viele, M Neumann, M Feiner, JR Watson, JJ Hopf, HW Toy, P
Williams EL, Hildebrand KL, McCormick SA, Bedel MJ: The effect of intravenous lactated Ringer’s solution versus 0.9% sodium chloride solution on serum osmolality in human volunteers. Anesth Analg 1999; 88: 999–1003Williams, EL Hildebrand, KL McCormick, SA Bedel, MJ