Incidence, Etiology and Outcomes of Hyponatremia after Transsphenoidal Surgery: Experience with 344 Consecutive Patients at a Single Tertiary CenterReport as inadecuate




Incidence, Etiology and Outcomes of Hyponatremia after Transsphenoidal Surgery: Experience with 344 Consecutive Patients at a Single Tertiary Center - Download this document for free, or read online. Document in PDF available to download.

Department of Neurosurgery, Houston Methodist Neurological Institute and the Kenneth R, Peak Brain and Pituitary Tumor Treatment Center, 6560 Fannin St. Suite 944, Houston, TX 77030, USA





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Abstract 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. View Full-Text

Keywords: hyponatremia; SIADH; pituitary adenoma; transsphenoidal; cerebral salt wasting hyponatremia; SIADH; pituitary adenoma; transsphenoidal; cerebral salt wasting





Author: Sean M. Barber, Brandon D. Liebelt and David S. Baskin *

Source: http://mdpi.com/



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