HYPONATREMIA AND SYNDROME OF INAPPROPRIATE ANTIDIURETIC-HORMONE SECRETION IN ADULT SPINAL SURGERY

被引:31
作者
CALLEWART, CC [1 ]
MINCHEW, JT [1 ]
KANIM, LEA [1 ]
TSAI, YC [1 ]
SALEHMOGHADDAM, S [1 ]
DAWSON, EG [1 ]
DELAMARTER, RB [1 ]
机构
[1] UNIV CALIF LOS ANGELES, SCH MED,DEPT ORTHOPAED SURG,100 UCLA MED PLAZA, SUITE 755, LOS ANGELES, CA 90024 USA
关键词
HYPONATREMIA; SERUM HYPO-OSMOLALITY; SPINAL SURGERY; SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE SECRETION; URINARY HYPEROSMOLALITY;
D O I
10.1097/00007632-199408000-00004
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. Patients undergoing spinal surgery were monitored for sodium balance, fluid type, and volume input and output during surgery and for the first 3 postoperative days. Objective. To prospectively document the true incidence of the syndrome of inappropriate antidiuretic hormone secretion and hyponatremia, and identify risk and protective factors for the development of the syndrome of inappropriate antidiuretic hormone secretion after spinal surgery. Methods. Data on medical history, surgical procedure, estimated blood loss, and volumes and types of intraoperative and postoperative fluids were collected on 116 consecutive spinal surgery patients during March to July 1992. Results. One hundred one spinal operations in 96 patients were evaluated. There were 48 males and 48 females, with a mean age of 52 years (range, 16 to 90 years). Hyponatremia developed in 45 (44.6%) patients. The etiology of hyponatremia was the syndrome of inappropriate antidiuretic hormone secretion in seven patients (6.9%), hypovolemia in 19 patients (18%), and other causes in six patients. Conclusions. Spine patients are at risk for hyponatremia and the syndrome of inappropriate antidiuretic hormone secretion. The incidence of the syndrome of inappropriate antidiuretic hormone secretion was 6.9%. Serum sodium should be monitored postoperatively. Patients who undergo a revision operation have an approximately two to four times greater risk of being affected by the syndrome of inappropriate antidiuretic hormone secretion than those who have primary surgery.
引用
收藏
页码:1674 / 1679
页数:6
相关论文
共 11 条
[1]  
Bell G.R., Gurd A.R., Orlowski J.P., Rish J.T., The syndrome of inappropriate antidiuretic-hormone secretion following spinal fusion, J Bone Joint Surg [Am], 68, pp. 720-724, (1986)
[2]  
Dali B.E., Stauffer E.S., Sendele R., Syndrome of inappropriate anti-diuretic hormone secretion complicating metrizamide myelography, J Bone Joint Surg [Am], 70, pp. 142-143, (1988)
[3]  
Deutsch S., Goldberg M., Dripps R.D., Postoperative hyponatremia with the inappropriate release of antidiuretic hormone, Anesthesiology, 27, pp. 250-256, (1966)
[4]  
Elster A.D., Hyponatremia after spinal fusion caused by inappropriate secretion of antidiuretic hormone (SIADH), Clin Orthop, 194, pp. 136-141, (1985)
[5]  
Flynn J.C., Kendra P.C., A Protocol to Modify the Inappropriate Antidiuretic Hormone Syndrome in Scoliosis Surgery Patients, pp. 23-26, (1992)
[6]  
Hsu T., Disorders of the pituitary gland, The Principles and Practice of Medicine, pp. 778-796, (1984)
[7]  
Moran W.H., Miltenberger F.W., Shuayb W.A., Zimmer-Mann B., The relationship of antidiuretic hormone secretion to surgical stress, Surgery, 56, pp. 99-108, (1964)
[8]  
Schwartz W.B., Bennett W., Curelop S., Bartter F.C., A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone, Am J Med, 23, pp. 529-542, (1957)
[9]  
Ting C., Eshaghpour E., Inappropriate secretion of antidiuretic hormone after open heart surgery, Am J Dis Child, 134, pp. 873-874, (1980)
[10]  
Philbin D.M., Coggins C.H., Plasma antidiuretic hormone levels in cardiac surgical patients during morphine and halo- thane anesthesia, Anesthesiology, 49, pp. 95-98, (1978)