Watterworth Blake S, Noorani Robert J
From the Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland.
A A Pract. 2018 Jul 15;11(2):54-56. doi: 10.1213/XAA.0000000000000738.
Correction of profound hyponatremia requires careful planning and close monitoring to reduce the risks of neurologic injury. Although there are various suggested treatment strategies in the setting of a medical ward or intensive care unit, reports of intraoperative management to prevent rapid increases in serum sodium are lacking. We present a case of profound hyponatremia of 102 mmol/L in a patient who required emergent operative repair for bowel obstruction. This is the first case to our knowledge that demonstrates a perioperative fluid and desmopressin treatment strategy to prevent overly rapid changes of sodium concentration in a patient with severe hyponatremia.
纠正严重低钠血症需要精心规划和密切监测，以降低神经损伤风险。尽管在普通病房或重症监护病房环境中有各种建议的治疗策略，但缺乏关于术中管理以防止血清钠快速升高的报道。我们报告一例严重低钠血症（血钠浓度为102 mmol/L）患者，该患者因肠梗阻需要紧急手术修复。据我们所知，这是首例展示围手术期液体和去氨加压素治疗策略以防止严重低钠血症患者钠浓度过度快速变化的病例。
