Hyponatremia, Cause and diagnosis

Keyword

Hyponatremia, Cause and diagnosis

Definition

Mild (130 to 134 mEq/L)

Moderate (120 to 130 mEq/L)

Severe (<120 mEq/L)

Cause and diagnosis

Serum osmolality

• normal : Pseudohyponatremia, Hyperlipidemia
• High : Hyperglycemia, Mannitol, TURP syndrome
• Low -> Volume status evaluation
• Hypovolemia : Ur[Na] >20 : Renal loss (diuretics, RTA, nephropathy 등)

Ur[Na]<20 : Extrarenal loss (설사. 구토, 췌장염, trauma)

• Euvolemia : Ur[Na] >20 : Glucocorticoid 부족, Hypothyroidism, SIADH, polydipsia

Ur[Na]<20 : Fluid depletion with hypotonic replacement

• Hypervolemia : Ur[Na] >20 : Renal failure

Ur[Na]<20 : Nephrotic syndrome, cardiac failure. cirrhosis

Signs & Symptoms

• Na >125 : asymptomatic
• 120< Na<125 : headache, anorexia, nausea, weakness, cerebral edema, 등
• Na <110 : seizure, coma

Anesthetic consideration

: Na >130 으로 유지하는 것이 안전

Reference

Miller’s Anesthesia, 8th edition, P., P. 1787 - 1789

Morgan and Mikhail's Clinical Anesthesiology, 5th edition, P 1117 - 1120