Unexpected fatal hypernatremia after successful cardiopulmonary resuscitation with therapeutic hypothermia: a case report

• Published in: Journal of Korean medical science 2012, 27(3), 161, pp.329-331
• Main Authors: Choi, Sang-Sik, Kim, Won Young, Kim, Won, Lim, Kyung-Su
• Format: Article
• Language: English
• Subjects: Adult; Cardiopulmonary Resuscitation - adverse effects; Case Report; Diabetes Insipidus, Neurogenic - diagnosis; Diabetes Insipidus, Neurogenic - etiology; Fatal Outcome; Female; Heart Arrest - complications; Heart Arrest - therapy; Humans; Hypernatremia - etiology; Hypothermia, Induced - adverse effects; Pulmonary Embolism - complications; 의학일반
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2012.27.3.329

Central diabetes insipidus (DI), characterized by unexpected fatal hypernatremia, is a rare complication after successful cardiopulmonary resuscitation with therapeutic hypothermia, but may be potentially fatal if recognition is delayed. We describe here a patient who experienced cardiac arrest due to a pulmonary embolism, followed by successful resuscitation after induction of therapeutic hypothermia. The patient, however, suddenly developed unexpected hypernatremia with increased urine output and was diagnosed with central DI as a complication of cerebral edema, and eventually died. Our findings suggest that central DI should be considered as a possible complication following unexpected hypernatremia with increased urine output during therapeutic hypothermia and that desmopressin acetate should be used to treat central DI.