Naslov
Postoperative euvolemic hyponatremia after finger amputation - Case report.

Autori
Miškić, Đuro ; Čančarević, Ognjen ; Zukanović, Sidbela ; Raguž, Antonija ; Miškić, Blaženka ; Jandrić-Balen, Marica

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Zbornik radova U: Liječnički vjesnik 2012 ; 134(suppl.3) / - , 2012

Skup
7. hrvatski internistički kongres s međunarodnim sudjelovanjem

Mjesto i datum
Opatija, Hrvatska, 27.09.2012. - 30.09.2012

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
Hyponatremia; postoperative period; finger amputation

Sažetak
INTRODUCTION: Hyponatremia is the most common of the electrolyte abnormalities in hospitalized patients. The mortality of acute symptomatic hyponatremia has been reported to be as high as 55%. The risk of mortality increase with the severity of hyponatremia (27% when serum sodium is <120mmol/L).The incidence of hospital acquired hyponatremia (Na+<135mmol/l) was reported to be between 20% and 25% ; in 30% of all patients in the intensive care unit, and in 87% of all hospitalized patients with congestive heart failure.Approximately 4, 4% of postoperative patients developed hyponatremia within 1 week of surgery. Patients with acute hyponatremia (developing over 48 hours or less) can get severe cerebral edema and death. Rapid identification and correction of serum sodium level is necessary to avert brainstem herniation and death. CASE REPORT: 63 years old man, previously known cardiopathy and diabetes type 2, was admitted to Surgical department for foot finger amputation. Glycemia was treated with rapid‐acting insulin and isotonic fluid, pain was treated with diclofenacum. Second postoperative day, he became confused with headache, he got muscle cramps and became delirant and somnolent. He had body temperature 37.5 C, respiratory rate 15/min, oxygen saturation 98%, puls 75/min, RR:120/80mmHg. Laboratory data showed L:11.49, Hgb:128, CRP:25.7mg/L, creatinine:67umol/L, BUN:6.6mmol/L, Na:106mmol/L, K:4.6mmol/L, chloride:79mmol/L, glucose:8mmol/L, serum bicarbonate:21.8mmol/L, uric acid:144umol/L, pH:7.343, serum osmolality: 237.8mosm/kg. He got parenteral hypertonic NaCl, furosemid and water restriction. After 48 hours patient became slightly better and 5th postoperative day asymptomatic. Complete correction of electrolyte disbalance was achived. It was acute hypotonic and euvolemic hyponatremia. All others performed speciment were normal. There was no evidence of malignancy or pshycotic behavior earlier. This acute hyponatremia was induced excessive ADH release as result of operative procedure, stress, pain and drugs. CONCLUSION: Continuine measurment of electrolytes during early postoperative period is crucial to prevent seriously postoperative hyponatremia.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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