Next Article in Journal / Special Issue
Hyponatraemia in Emergency Medical Admissions—Outcomes and Costs
Previous Article in Journal
Obesity as an Early Symptom of the AMIS Syndrome
Previous Article in Special Issue
Effects of Hyponatremia on the Brain
Article Menu

Export Article

Open AccessArticle
J. Clin. Med. 2014, 3(4), 1199-1219; doi:10.3390/jcm3041199

Incidence, Etiology and Outcomes of Hyponatremia after Transsphenoidal Surgery: Experience with 344 Consecutive Patients at a Single Tertiary Center

Department of Neurosurgery, Houston Methodist Neurological Institute and the Kenneth R, Peak Brain and Pituitary Tumor Treatment Center, 6560 Fannin St. Suite 944, Houston, TX 77030, USA
*
Author to whom correspondence should be addressed.
Received: 30 July 2014 / Revised: 23 September 2014 / Accepted: 27 September 2014 / Published: 28 October 2014
(This article belongs to the Special Issue Hyponatremia: Advances in Diagnosis and Management)
View Full-Text   |   Download PDF [839 KB, uploaded 28 October 2014]   |  

Abstract

Hyponatremia is often seen after transsphenoidal surgery and is a source of considerable economic burden and patient-related morbidity and mortality. We performed a retrospective review of 344 patients who underwent transsphenoidal surgery at our institution between 2006 and 2012. Postoperative hyponatremia was seen in 18.0% of patients at a mean of 3.9 days postoperatively. Hyponatremia was most commonly mild (51.6%) and clinically asymptomatic (93.8%). SIADH was the primary cause of hyponatremia in the majority of cases (n = 44, 71.0%), followed by cerebral salt wasting (n = 15, 24.2%) and desmopressin over-administration (n = 3, 4.8%). The incidence of postoperative hyponatremia was significantly higher in patients with cardiac, renal and/or thyroid disease (p = 0.0034, Objective Risk (OR) = 2.60) and in female patients (p = 0.011, OR = 2.18) or patients undergoing post-operative cerebrospinal fluid drainage (p = 0.0006). Treatment with hypertonic saline (OR = −2.4, p = 0.10) and sodium chloride tablets (OR = −1.57, p = 0.45) was associated with a non-significant trend toward faster resolution of hyponatremia. The use of fluid restriction and diuretics should be de-emphasized in the treatment of post-transsphenoidal hyponatremia, as they have not been shown to significantly alter the time-course to the restoration of sodium balance. View Full-Text
Keywords: hyponatremia; SIADH; pituitary adenoma; transsphenoidal; cerebral salt wasting hyponatremia; SIADH; pituitary adenoma; transsphenoidal; cerebral salt wasting
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Scifeed alert for new publications

Never miss any articles matching your research from any publisher
  • Get alerts for new papers matching your research
  • Find out the new papers from selected authors
  • Updated daily for 49'000+ journals and 6000+ publishers
  • Define your Scifeed now

SciFeed Share & Cite This Article

MDPI and ACS Style

Barber, S.M.; Liebelt, B.D.; Baskin, D.S. Incidence, Etiology and Outcomes of Hyponatremia after Transsphenoidal Surgery: Experience with 344 Consecutive Patients at a Single Tertiary Center. J. Clin. Med. 2014, 3, 1199-1219.

Show more citation formats Show less citations formats

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
J. Clin. Med. EISSN 2077-0383 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top