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Letters |15 June 1997

Postoperative Hyponatremia

Mitchell Halperin, MD, FRCP(C); Manjula Gowrishankar, MD, FRCP(C); C. David Mazer, MD, FRCP(C)

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  • University of Toronto, Toronto, Ontario M5B 1A6, Canada
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Ayus and Arieff's letter deserves clarification on three points.
First, can the plasma sodium level decrease to 120 mmol/L if only isotonic saline was infused? It is universally agreed that severe hyponatremia must be avoided immediately after surgery. Anything that adds electrolyte-free water (for example, hypotonic infusions or desalination of isotonic saline) when antidiuretic hormone acts contributes to the degree of hyponatremia and should be minimized. Moreover, the amount given relative to body size is important. A calculation might help here. Almost 15% of total body water must be retained as electrolyte-free water to cause the plasma sodium...
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Halperin M, Gowrishankar M, Mazer CD. Postoperative Hyponatremia. Ann Intern Med. 1997;126:1006. doi: 10.7326/0003-4819-126-12-199706150-00031

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Published: Ann Intern Med. 1997;126(12):1006.

DOI: 10.7326/0003-4819-126-12-199706150-00031

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