Central diabetes insipidus : a rare perioperative cause of severe hypernatraemia

In this case report we describe the management of severe hypernatraemia following inadvertent water restriction. A 21-year-old woman with no reported medical history presented on transfer from an outside hospital with a complex volar upper extremity injury. Management both operatively and postoperat...

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Bibliographic Details
Published in:Anaesthesia and intensive care 2008-03, Vol.36 (2), p.235-241
Main Authors: HAYANGA, A. J, KOHEN, R, EGELAND, B, CHARLES, A, SPOOR, M, KUZON, W. M, NAPOLITANO, L. M
Format: Article
Language:English
Subjects:
Adult
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Brain - pathology
Care and treatment
Case studies
Deamino Arginine Vasopressin - therapeutic use
Development and progression
Diabetes Insipidus - complications
Diabetes Insipidus - metabolism
Diagnosis
Female
Humans
Hypernatremia
Hypernatremia - etiology
Hypernatremia - metabolism
Intraoperative Complications - etiology
Intraoperative Complications - metabolism
Magnetic Resonance Imaging
Medical sciences
Osmolar Concentration
Patient outcomes
Perioperative care
Renal Agents - therapeutic use
Resuscitation
Sodium - blood
Tendon Injuries - surgery
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Summary:In this case report we describe the management of severe hypernatraemia following inadvertent water restriction. A 21-year-old woman with no reported medical history presented on transfer from an outside hospital with a complex volar upper extremity injury. Management both operatively and postoperatively involved a prolonged period of fasting which limited her access to drinking water Collateral history revealed that she had previously drunk copious amounts of water during the course of any given day and this had served to alleviate the dramatic symptoms of hypernatraemia that were rapidly manifest when her normal intake was curtailed. We outline the fluid management, administration of desmopressin and her subsequent recovery. A literature review of the management of central diabetes insipidus is also covered.
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057X0803600215