Garrett Raymond E, Wilhelm Stacia, Maerz Gary, Bar-Or David
Trauma Research Department, Swedish Medical Center, 501 E. Hampden Avenue, Room 4-454, Englewood, CO 80113, USA.
J Spinal Cord Med. 2010;33(1):65-7. doi: 10.1080/10790268.2010.11689675.
BACKGROUND/OBJECTIVE: To report successful use of a modified protocol of vasopressin receptor antagonist for effective and safe treatment of hyponatremia in a complexly ill patient in the neurorehabilitation setting.
Case report.
PARTICIPANTS/METHODS: A 57-year-old man with tetraparesis and protracted hyponatremia resistant to standard therapies.
This patient's rehabilitation from epidural abscess-induced tetraplegia was complicated by symptomatic hyponatremia. The pathophysiology was multifactorial. The course was prolonged, and several therapeutic endeavors failed. Intravenous infusions of vasopressin receptor antagonist induced and maintained eunatremia. The pace of the patient's recovery improved, and he was discharged with substantial neurologic recovery. No central nervous system toxicities of the treatments were observed.
Intravenous vasopressin receptor antagonist is an effective and safe treatment for hyponatremia in the rehabilitation setting if the dosage and monitoring protocols are modified in accordance with the physiology of the patient with spinal cord injury.
背景/目的：报告成功使用血管加压素受体拮抗剂的改良方案，有效且安全地治疗神经康复环境中病情复杂患者的低钠血症。
病例报告。
参与者/方法：一名57岁男性，患有四肢轻瘫和对标准治疗有抵抗性的持续性低钠血症。
该患者因硬膜外脓肿导致四肢瘫痪，康复过程中出现症状性低钠血症，病理生理是多因素的。病程延长，多次治疗尝试失败。静脉输注血管加压素受体拮抗剂诱导并维持了血钠正常。患者恢复速度加快，出院时神经功能有显著恢复。未观察到治疗的中枢神经系统毒性。
如果根据脊髓损伤患者的生理情况调整剂量和监测方案，静脉注射血管加压素受体拮抗剂是康复环境中治疗低钠血症的有效且安全的方法。
