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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Clin+Med
2014 ; 3
(4
): 1199-219
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Incidence, Etiology and Outcomes of Hyponatremia after Transsphenoidal Surgery:
Experience with 344 Consecutive Patients at a Single Tertiary Center
#MMPMID26237599
Barber SM
; Liebelt BD
; Baskin DS
J Clin Med
2014[Oct]; 3
(4
): 1199-219
PMID26237599
show ga
Hyponatremia is often seen after transsphenoidal surgery and is a source of
considerable economic burden and patient-related morbidity and mortality. We
performed a retrospective review of 344 patients who underwent transsphenoidal
surgery at our institution between 2006 and 2012. Postoperative hyponatremia was
seen in 18.0% of patients at a mean of 3.9 days postoperatively. Hyponatremia was
most commonly mild (51.6%) and clinically asymptomatic (93.8%). SIADH was the
primary cause of hyponatremia in the majority of cases (n = 44, 71.0%), followed
by cerebral salt wasting (n = 15, 24.2%) and desmopressin over-administration (n
= 3, 4.8%). The incidence of postoperative hyponatremia was significantly higher
in patients with cardiac, renal and/or thyroid disease (p = 0.0034, Objective
Risk (OR) = 2.60) and in female patients (p = 0.011, OR = 2.18) or patients
undergoing post-operative cerebrospinal fluid drainage (p = 0.0006). Treatment
with hypertonic saline (OR = -2.4, p = 0.10) and sodium chloride tablets (OR =
-1.57, p = 0.45) was associated with a non-significant trend toward faster
resolution of hyponatremia. The use of fluid restriction and diuretics should be
de-emphasized in the treatment of post-transsphenoidal hyponatremia, as they have
not been shown to significantly alter the time-course to the restoration of
sodium balance.