Keyword
Postoperative hyponatremia
Definition
Surgical stress response, pain-related or physiologic stress–related sympathetic activity로
SIADH와 유사하게 water retention 됨
Incidence
Children and premenopausal females 에서 잘 생김. ( 1~5%)
노인의 경우 120 mEq/L이상에서 증상이 잘 나타나지 않으나 위의 group에서는
128 mEq/L이상인 경우에도 symptoms and neurologic sequelae가 잘 나타남.
Symtoms
8% encephalopathy, 52% permanent neurologic sequelae or death.
Prevention
Postoperative fluid therapy : pure maintenance requirements (1 to 1.2 mL/kg/hr)
Replacing losses of Na+- with Isotonic salt solution
Reference
Miller’s Anesthesia, 8th edition, P.1788