Hyponatremia after hip arthroplasty may be related to a translocational rather than to a dilutional mechanism

Guglielminotti, Jean; Tao, Stéphanie; Maury, Éric; Fierobe, Lisiane; Mantz, Jean; Desmonts, Jean-Marie

doi:10.1097/01.ccm.0000045547.12683.63

Cited by 18 publications

(10 citation statements)

References 29 publications

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“…Other factors contributing to the development of hyponatraemia in hospitalised patients include the syndrome of inappropriate antidiuretic hormone secretion (SIADH), thiazide diuretics, selective serotonin reuptake inhibitor antidepressants, hypotonic intravenous fluids and surgery [4,13]. Post-operatively, the release of intracellular osmotically active solutes leading to cellular water shift into extracellular spaces (sick cell syndrome) has also been implicated [16,17]. Delirium and cerebral oedema have been noted in acute hyponatraemia and osmotic demyelination syndrome can occur after rapid correction of chronic hyponatraemia [1].…”

Section: Discussionmentioning

confidence: 99%

Analysis of hyponatraemia associated post-operative mortality in 3897 hip fracture patients

Tinning

Cochrane

Singer

2015

Injury

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Section: Discussionmentioning

confidence: 99%

Analysis of hyponatraemia associated post-operative mortality in 3897 hip fracture patients

Tinning

Cochrane

Singer

2015

Injury

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“…It was replaced by the current surgical and critical care paradigm: large quantities of salt and water are necessary postoperatively to prevent shock and preserve end‐organ function. Much attention has been focused on the prevention of postoperative hyponatraemia (12–24), often by emphasising the role of salt‐rich fluid postoperatively, although experimental work suggests that sodium administration may not prevent the phenomenon (14,22). Recently, several groups have observed that salt and water administration, even in the quantities recommended by many texts, appears to increase the risk of postoperative complications in colorectal patients (1–3), probably due to tissue oedema and hypoxaemia.…”

Section: Discussionmentioning

confidence: 99%

Perioperative fluid management: prospective audit

Walsh

Cook

Bentley

et al. 2007

International Journal of Clinical Practice

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“…13 Mekanisme lainnya adalah cerebral salt wasting (CSW), hiponatremia translokasional, dan sick cell syndrome. 8,17,18 Risiko terjadinya hiponatremia pasca-operasi serta potensi bahaya yang ditimbulkan belum banyak disadari oleh para dokter yang bekerja di ruang perawatan intensif sehingga peneliti merasa bahwa penelitian mengenai hiponatremia pada pasien anak pasca-operasi perlu dilakukan.…”

Section: Hiponatremia Pada Anak Pasca Tindakan Operasi : Etiologi Danunclassified

“…Sick cell syndrome merupakan kondisi yang dikaitkan dengan sakit kritis sehingga kejadian hiponatremia akibat SCS diperkirakan akan lebih banyak terjadi pada jam-jam awal pasca-operasi. 18 Sedangkan pada SHATT kondisi hiponatremia sangat berhubungan dengan peningkatan sekresi HAD, yang mencapai puncak pada 12 jam setelah operasi dan masih dapat bertahan hingga 3-5 hari. 5,11,12,27 Penyebab adanya perbedaan etiopatogenesis hiponatremia pada penelitian ini dengan beberapa penelitian lain, yang menunjukkan SHATT sebagai etiologi tersering, belum dapat diketahui.…”

Section: Pembahasanunclassified

Hiponatremia pada Anak Pasca Tindakan Operasi : Etiologi dan Faktor-faktor yang Berhubungan

Arifin¹,

Pudjiadi²,

Handryastuti³

et al. 2017

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Latar belakang. Kejadian hiponatremia pada anak pasca-operasi berkisar antara 20-40%. Hiponatremia yang tidak terdeteksi dapat meningkatkan mortalitas dan menyebabkan luaran neurologis yang buruk. Beberapa mekanisme yang berperan adalah sindrom hormon antidiuretik tidak tepat (SHATT) dan sick cell syndrome (SCS). Tujuan. Mengetahui insidens hiponatremia pada anak pasca-operasi, kemungkinan penyebab yang melatarbelakangi, serta faktor yang berhubungan. Metode. Penelitian potong lintang analitik dilakukan di ruang perawatan intensif terhadap anak berusia 1 bulan sampai 18 tahun yang menjalani tindakan operasi mayor dan masuk ruang perawatan intensif pediatrik RSCM selama bulan Mei sampai Desember 2016. Hasil. Terdapat 65 subyek menjalani operasi mayor, 87,69% dilakukan secara elektif, jenis operasi terbanyak adalah hepatogastrointestinal (38,46%) dan muskuloskeletal (20,00%). Kadar natrium plasma pasca-operasi turun, kejadian hiponatremia 43,07% dan 26,16% pada 12 dan 24 jam pasca-operasi. Nilai osmolalitas plasma yang normal atau meningkat dan osmolalitas urin >100 mOsm/kg. Sebanyak 70% subyek hiponatremia memiliki natrium urin >30 mEq/L. Faktor yang berhubungan dengan hiponatremia 12 jam pasca-operasi adalah status kegawatdaruratan operasi (p=0,007) dan perdarahan intraoperatif (p=0,024), sedangkan pada 24 jam pasca-operasi hanya status kegawatdaruratan operasi (p=0,001). Kesimpulan. Terdapat 43,07% dan 26,16% subyek yang mengalami hiponatremia pada 12 dan 24 jam pasca-operasi mayor. Sindrom hormon antidiuretik tidak tepat tidak terbukti menjadi penyebab utama terjadinya hiponatremia, dan hiponatremia translokasional pada SCS mungkin berperan. Hiponatremia pasca-operasi berhubungan dengan status kegawatdaruratan operasi dan jumlah perdarahan intraoperatif. Sari Pediatri 2017;19(2):63-70Kata kunci: hiponatremia, pasca-operasi, hormon antidiuretik, sick cell sydrome Hyponatremia in Post-surgery Pediatric Patients: Etiology and Its Related FactorsAngelina, Antonius H. Pudjiadi, Setyo Handryastuti, Idham Amir, Evita B. Ifran, Mulya R. KaryantiBackground. The incidence of hyponatremia in post-surgery pediatric patients is 20-40%. Undetected hyponatremia correlates with higher mortality and poor neurology outcomes. There are several mechanisms in post-surgery hyponatremia, such as syndrome of inappropriate antidiuretic hormone and sick cell syndrome. Objective. To establish the incidence of hyponatremia among post-surgery pediatric patients, possible etiologies, and its related factors. Method. Observational analytic study was conducted forchildren aged 1 month until 18 years old after underwent major surgery in CM hospital pediatric intensive care unit, between May and December 2016. Results. There were 65 subjects underwent mayor surgery, mostly (87.69%) were elective surgery. The most common surgeries were hepato-gastrointestinal (38,46%) and musculoskeletal (20,00%) surgery. There was significant reductionof plasma natrium after surgery, with hyponatremia incidence at 12 and 24 hours post-surgery were 43.07% and 2...

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Hyponatremia after hip arthroplasty may be related to a translocational rather than to a dilutional mechanism

Cited by 18 publications

References 29 publications

Analysis of hyponatraemia associated post-operative mortality in 3897 hip fracture patients

Analysis of hyponatraemia associated post-operative mortality in 3897 hip fracture patients

Perioperative fluid management: prospective audit

Hiponatremia pada Anak Pasca Tindakan Operasi : Etiologi dan Faktor-faktor yang Berhubungan

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